1- Ph D. Student, Department of Economics, Kho.C., Islamic Azad University, Khomeinishahr, Iran.
2- Assistant Professor, Department of Economics, Kho.C., Islamic Azad University, Khomeinishahr, Iran. ,shr_tofighi@yahoo.com
3- Assistant Professor, Department of Economics, Isf.C., Islamic Azad University, Isfahan, Iran.
2- Assistant Professor, Department of Economics, Kho.C., Islamic Azad University, Khomeinishahr, Iran. ,
3- Assistant Professor, Department of Economics, Isf.C., Islamic Azad University, Isfahan, Iran.
Abstract: (210 Views)
Introduction: Given the growth of the elderly population and limited infrastructure and financial resources, this study aimed to identify and analyze the supply–demand relationships of resources in Iran’s elderly care system.
Method: This mixed-method study was conducted in 2024. Preliminary components of the population and economy, resource demand, and service supply subsystems were extracted through a literature review. Then, using the fuzzy Delphi method over three consecutive rounds with 20 experts, 11 key components were identified. In the first round, 10 of the initial 11 components were confirmed, and 15 expert-suggested components (e.g., elderly education level and mobile health services) were evaluated. In the second round, only the average cost of health services was confirmed. In the third round, the final 11 components were finalized by expert consensus. The DEMATEL method was applied to analyze causal relationships and determine the influential and dependent components.
Results: The study revealed that components such as the proportion of the elderly population and the number of specialized elderly care centers are dependent, whereas components such as average annual income and the number of elderly patients under treatment are influential. Based on the D−R index, six components were classified as influential and five as dependent.
Conclusion: This study provides a structural framework for improving resource allocation in Iran’s elderly care system. The findings emphasize strengthening influential factors and making targeted investments in dependent infrastructure to improve resource allocation and the quality of elderly care services.
Method: This mixed-method study was conducted in 2024. Preliminary components of the population and economy, resource demand, and service supply subsystems were extracted through a literature review. Then, using the fuzzy Delphi method over three consecutive rounds with 20 experts, 11 key components were identified. In the first round, 10 of the initial 11 components were confirmed, and 15 expert-suggested components (e.g., elderly education level and mobile health services) were evaluated. In the second round, only the average cost of health services was confirmed. In the third round, the final 11 components were finalized by expert consensus. The DEMATEL method was applied to analyze causal relationships and determine the influential and dependent components.
Results: The study revealed that components such as the proportion of the elderly population and the number of specialized elderly care centers are dependent, whereas components such as average annual income and the number of elderly patients under treatment are influential. Based on the D−R index, six components were classified as influential and five as dependent.
Conclusion: This study provides a structural framework for improving resource allocation in Iran’s elderly care system. The findings emphasize strengthening influential factors and making targeted investments in dependent infrastructure to improve resource allocation and the quality of elderly care services.
References
1. Dehghan Banadaki M. Investigating the state of aging in Iran: future prospects and challenges. Monthly Report of the Islamic Parliament Research Center. 2023; 31(4): e19086. Available from: https://report.mrc.ir/article_9583.html
2. Ghasemyani S, Jafari M, Teymourlouy AA, Fadayevatan R. Components of elderly long-term care system in Iran and selected countries: A comparative study. Health Scope. 2021;10(3):e109140. [DOI:10.5812/jhealthscope.109140]
3. Mobasseri K, Ghasemyani S, Khodayari-Zarnaq R, Kousha A. Developing a comprehensive model of home-based long-term care for older people in Iran: a multi-method study. BMC Health Services Research. 2025;25(1):298. [DOI:10.1186/s12913-025-12434-0]
4. Tafesse W, Jemutai J, Mayora C, Margini F. Scoping review of health economics research on refugee health in sub-Saharan Africa. Value in Health Regional Issues. 2024;39:98-106. [DOI:10.1016/j.vhri.2023.10.008]
5. Cui X, Chang CT. Matching and coordination among elderly services, aging, and economy in China. Mathematical Problems in Engineering. 2021;2021:1-11. [DOI:10.1155/2021/5552644]
6. Ma Y. The Relationship Between Aging, Economic Development and Healthcare Expenditure in Japan: An Empirical Analysis. SHS Web of Conferences. 2024; 181. 04012. [DOI:10.1051/shsconf/202418104012]
7. Rani K, Revanth R, Shanmughavadivu N, Flower FLL. Economic soundness and Psychological Well-being among the Elderly. South Asian Journal of Social Sciences and Humanities. 2023;4(2):1-11. [DOI:10.48165/sajssh.2023.4201]
8. You RY, Zhang H, Lu CP. "EN-GAWA SERVICE" Concept for Long-Term Care Service Institution, Tainan YMCA. Environment-Behaviour Proceedings Journal. 2023;8(23):295-301. [DOI:10.21834/ebpj.v8i23.4347]
9. Shen X, Zhou S, Zhang X. Services for Aging Persons in China: Spatial Variations in Supply and Demand. Springer Nature; 2022. [DOI:10.1007/978-3-030-98032-0]
10. Vecillas Martin D, Berruezo Fernández C, Gento Municio AM. Systematic Review of Discrete Event Simulation in Healthcare and Statistics Distributions. Applied Sciences. 2025;15(4):1861. [DOI:10.3390/app15041861]
11. Linnéusson G, Goienetxea Uriarte A. Learning from simulating with system dynamics in healthcare: evaluating closer care strategies for elderly patients. Journal of Simulation. 2023;17(5):557-79. [DOI:10.1080/17477778.2023.2232768]
12. Zhang Y, Zhang M, Hu H, He X. Spatio-temporal characteristics of the supply and demand coupling coordination of elderly care service resources in China. International Journal of Environmental Research and Public Health. 2022;19(16):10397. [DOI:10.3390/ijerph191610397]
13. Maleki, M., Abbaspour, A., Nouri Hekmat, S., Borzoian, S. Identifying approaches and models for predicting physician supply and demand in the health system of OECD countries. Medical Journal of Mashhad university of Medical Sciences, 2024; 67(6): 1558-74 [In Persian]. [DOI:10.22038/mjms.2024.83991.4828]
14. Jafari, F., Asghari Zamani, A., soleimanirad, E. Modeling the Changes in the Population Age Structure with an Emphasis on Medical Services' State (Case Study: Tabriz City). Journal of Urban Structure and Function Studies. 2023; 10(36): 205-231 [In Persian]. [DOI:10.22080/usfs.2023.25061.2341]
15. Mohammadi RK, Shakib MH, Khodam M, Ramezani A. Implementation of fuzzy delphi method in designing AI-based social banking model for Iranian cooperative banks. Fuzzy Optimization and Modeling Journal (FOMJ). 2024; 5(4):76-97. [DOI:10.71808/fomj.2024.1193172]
16. Bahmaei J, Ravangard R, Bahrami MA, Asadollahi A, Bastani P. Policy requirements in promoting older people health care in Iran: A qualitative study. Journal of Education and Health Promotion. 2023;12(1):159. [DOI:10.4103/jehp.jehp_939_22]
17. Jabbari A, Zakeri A, Saghafi F, Hadian M. Iranian health financing system challenges to promote health outcomes: Qualitative study. Journal of Education and Health Promotion. 2023;12(1):149. [DOI:10.4103/jehp.jehp_507_22]
18. Van den Heede K, Bouckaert N, Van de Voorde C. The impact of an ageing population on the required hospital capacity: results from forecast analysis on administrative data. European Geriatric Medicine. 2019;10(5):697-705. [DOI:10.1007/s41999-019-00219-8]
19. Sahoo PM, Rout HS, Jakovljevic M. Consequences of India's population aging to its healthcare financing and provision. Journal of Medical Economics. 2023;26(1):308-15. [DOI:10.1080/13696998.2023.2178164]
20. Abedini A, Irani H R, Yazdani H R. Identify and Prioritize the Critical Success Factors in Pharmaceutical Supply Chain and Distribution Using the DEMETEL Technique. Payavard. 2019; 13 (1):45-59. [In Persian]. http://payavard.tums.ac.ir/article-1-6728-en.html
21. Farhadi P, Niyas M, Shokrpour N, Ravangard R. Prioritizing factors affecting health service quality using integrated fuzzy DEMATEL and ANP: a case of Iran. The Open Public Health Journal. 2020;13(1): 263-272. [In Persian]. [DOI:10.2174/1874944502013010263]
22. Malmir R, Jafari M, Maher A, Hosseini SM, Alimohammadzadeh K. Factors affecting fair access to outpatient services in Iranian healthcare system using Dematel approach. Journal of Iranian Medical Council. 2021;4(4):221-31. https://dor.isc.ac/dor/20.1001.1.2645338.2021.4.4.4.1
23. Gupta N, Vrat P, Ojha R. Prioritizing enablers for service quality in healthcare sector-a DEMATEL approach. Journal of Health Organization and Management. 2022;36(5):633-49.
https://doi.org/10.1108/JHOM-06-2021-0222 [DOI:10.1108/jhom-06-2021-0222]
24. Zanjari, N., Elsagh, A. A., sadeghi, R., Nouri, M. Factors Affecting Life Satisfaction of the Elderly People in Tehran. Journal of Social Work Research. 2018; 5(16): 101-26. [In Persian]. [DOI:10.22054/rjsw.2018.11706]
25. Gholipour Z, Gholipour L, Hajnabi K, Mahmoodi M. The Role of Psychological Empowerment in the Prediction of Psychological Well - Being in Health Care Workers ran. Journal of Health Management. 2019; 10(2): 61-72. [In Persian]
26. Liao CH. Evaluating the social marketing success criteria in health promotion: a F-DEMATEL approach. International Journal of Environmental Research and Public Health. 2020;17(17):6317. [DOI:10.3390/ijerph17176317]
27. Akbari M, Alimohamadzadeh K, Maher A, Hosseini SM, Bahadori M. Systematic analysis the barriers to the integration of health insurance in Iran using the dematel approach. Journal of Military Medicine. 2021;23(1):90-101. [DOI:10.30491/JMM.23.1.90]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Site Keywords
Health, Administration, Scientific Article, Iran University of Medical Sciences,
