Designing an interpretive structure model for a blockchain technology-based treatment cost management model in the Iranian health system

Document Type : Original Article

Authors
nahid nargesi 1
fatemeh ahmadi 2
sadegh feizollahi 3
rahmatollah Mohammadipour 2
1 Department of Accounting and Finance, Ilam Branch, Islamic Azad University, Ilam, Iran.
2 Department of Accounting and Finance, Ilam Branch, Islamic Azad University, Ilam, Iran
3 Department of Management, Ilam Branch, Islamic Azad University, Ilam, Iran.
10.22034/jmaak.2025.78132.4447
Abstract
The digital revolution and the emergence of new technologies such as blockchain have created new opportunities for transformation in various industries, including health. In the meantime, treatment cost management, as one of the main concerns of health systems, is not exempt from this transformation. The present study aimed to design a treatment cost management model based on blockchain technology in the Iranian health system based on interpretive structural modeling. This research is exploratory in terms of purpose and qualitative in terms of approach. In this study, 15 experts were interviewed. The snowball method was used to collect information, and then the information extracted from the texts and interviews was categorized and analyzed using the content analysis method. Considering the intended goals, semi-structured interviews and text review based on the content analysis strategy were used to collect data. Finally, the themes were classified using the Clark and Brown method. The organizing themes included: technological factors, financial factors, information system management, supply chain and logistics, human resource management and optimization, which was finally obtained based on the interpretive structural modeling method. It can be said that blockchain technology can create a transformation in the financial and management structures of the health system. Also, as a secure and transparent technology, it can help manage treatment costs and prevent corruption, financial errors, and waste of resources.
Keywords
Cost management
treatment
blockchain technology
Iranian health system
interpretive structure
  1. آل یاسین،  سیده سما و پور زمانی، زهرا. (1401). توسعه مدل پذیرش فناوری بلاکچین در بستر مفاهیم حسابداری مدیریت فصلنامه اقتصاد مالی، دوره چهارم، شماره16، زمستان 1401 .
  2. چیت ساز، احمد؛ قربانی حصاری، محمد؛ فیلی، هلیا. (1399) شناسایی عوامل مؤثر بر عدم موفقیت تأمین مالی جمعی مبتنی بر بلاک‌چین با استفاده از عرضه اولیه بهامُهر، فصلنامه علمی پژوهشی توسعه کارآفرینی.
  3. حسینی سرخوش، سید مهدی.(1401). در تحقیقی به اولویت‌بندی عوامل مرتبط با پذیرش فناوری بلاک‌چین در نظام پرونده الکترونیک سلامت. مدیریت اطلاعات سلامت. دوره 19، شماره 2 - شماره پیاپی 84 خرداد و تیر 1401 صفحه71-78.
  4. رحیمی، احمد؛ بوشهری، علی. (1398). بررسی نقش فناوری بلاکچین در بهبود عملکرد زنجیره تامین صنایع دفاعی، اولین کنفرانس بین المللی مدیریت دانش، بلاکچین و اقتصاد، تهران.

5.       زارع عسکری، علی و همکاران.(1401). طراحی و اعتبارسنجی الگوی مدیریت هزینه پرونده‌های بستری در نظام گلوبال( مطالعه موردی در بیمارستان تک تخصصی زنان و زایمان نیک نفس رفسنجان). طلوع بهداشت.; دوره اول، شماره 21 ،۱۷-۳۰

6.       مزینانی عباس، میرمحمدخانی مجید، نجفی لیلا، رشدی اسرافیل. (1403). طراحی یک الگوی کارا برای مدیریت هزینه‌های درمان غیرجراحی سرطان در ایران. ارمغان دانش. دوره اول، شماره 29.

  1. مسرت، الهام و همکاران. (1401). امکان‌سنجی پیاده‌سازی فناوری بلاک‌چین و اینترنت اشیا در بیمارستان‌های وابسته به دانشگاه علوم‌ پزشکی تبریز از دیدگاه کاربران. اطلاع‌رسانی پزشکی نوین. دوره هشتم، شماره سوم، ۲۸۲-۲۹۳
  2. مصدق راد، علیمحمد و همکاران. (1400). راهکارهای تأمین مالی پایدار نظام سلامت ایران: یک مرور حیطه ای مجله دانشکده بهداشت و انستیتو تحقیقات بهداشتی تابستان 1400 ، دوره 19 ، شماره دوم صفحه 137- 156.
  3. میرزایی، اباسط؛ حسینی، فاطمه. (1399). بررسی تاثیر فناوری اطلاعات بر نظام سلامت و مدیریت اطلاعات بهداشتی ودرمانی،هفتمین کنفرانس بین المللی پژوهش در مدیریت، اقتصاد و توسعه.

10.  Abbas HSM, Qaisar ZH, Ali G, Alturise F, Alkhalifah T (2022) Impact of cybersecurity measures on improving institutional governance and digitalization for sustainable healthcare. PLoS ONE 17(11): e0274550. https://doi.org/10.1371/ journal.pone.027455.

11.  Apipi, M., Abdul Rasid, S. Z., & Basiruddin, R. (2024). Cost-benefit Analysis of Adopting Blockchain Technology in the Radiology Unit of a District Hospital. Journal of Health Management, 26(2), 256-264.

12.  Chandra, A., Flack, E., & Obermeyer, Z. (2021). The health costs of cost-sharing (No. w28439). National Bureau of Economic Research.

13.  Elangovan, D., Long, C. S., Bakrin, F. S., Tan, C. S., Goh, K. W., Hussain, Z., ... & Ming, L. C. (2020). Application of blockchain technology in hospital information system. Mathematical modeling and soft computing in epidemiology, 231-246.

14.  Fodor, R., Voiță-Mekeres, F., Cheregi, C. D., Indrieș, M., Noor, H., Pop, N. O., ... & Marcu, O. A. (2023). Epidemiological study on spinal cord injuries in a hospital from north-west of Romania. Pharmacophore, 14(1-2023), 80-86.

15.  Gökalp, E., Gökalp, M.O., Çoban, S., Eren, P.E. (2018). Analysing Opportunities and Challenges of Integrated Blockchain Technologies in Healthcare. In: Wrycza, S., Maślankowski, J. (eds) Information Systems: Research, Development, Applications, Education. SIGSAND/PLAIS 2018. Lecture Notes in Business Information Processing, vol 333. Springer, Cham. https://doi.org/10.1007/978-3-030-00060-8_13

16.  Han, H., Shiwakoti, R. K., Jarvis, R., Mordi, C., & Botchie, D. (2023). Accounting and auditing with blockchain technology and artificial Intelligence: A literature review. International Journal of Accounting Information Systems, 48, 100598.

17.  Hasan, K. M. B., Sajid, M., Lapina, M. A., Shahid, M., & Kotecha, K. (2024). Blockchain technology meets 6 G wireless networks: A systematic survey. Alexandria Engineering Journal, 92, 199-220.

18.  Hasselgren, A., Kralevska, K., Gligoroski, D., Pedersen, S. A., & Faxvaag, A. (2020). Blockchain in healthcare and health sciences—A scoping review. International Journal of Medical Informatics, 134, 104040.

19.  Jiménez Carabalí, V. J. (2018). The dynamics of cost management practices in portuguese hospitals.

20.  Kannan Govindan, Arash Khalili Nasr, Mohammad Saeed Heidary, Saeede Nosrati-Abarghooee & Hassan Mina (2023) Prioritizing adoption barriers of platforms based on blockchain technology from balanced scorecard perspectives in healthcare industry: a structural approach, International Journal of Production Research, 61:11, 3512-3526, DOI:10.1080/00207543.2021.2013560

21.  Kara, O., Kurutkan, M.N. (2021). Applications of Blockchain Technologies in Health Services: A General Framework for Policymakers. In: Bozkuş Kahyaoğlu, S. (eds) The Impact of Artificial Intelligence on Governance, Economics and Finance, Volume I. Accounting, Finance, Sustainability, Governance & Fraud: Theory and Application. Springer, Singapore. https://doi.org/10.1007/978-981-33-6811-8_11

22.  Lascu, C. F., Cheregi, C. D., Davidescu, L., & Manole, F. (2023). A Review of Factors, Drivers, and Barriers to Improving Hospital Cost Management. Entomology and Applied Science Letters, 10(2-2023), 50-55.

23.  Lee, I., & Shin, Y. J. (2018). Fintech: Ecosystem, business models, investment decisions, and challenges. Business horizons, 61(1), 35-46.

24.  Marques, I. C. P., & de Carvalho, A. K. M. (2020). Evolution of studies on orthopaedic surgery regarding cost management tools: a systematic literature review. Journal of Orthopaedics and Sports Medicine, 2(2), 61-88.

25.  Marques, I. C., & Alves, M. C. (2023). Hospital Costing Methods: Four Decades of Literature Review. Journal of Risk and Financial Management, 16(10), 433.

26.  Matahir, H., Yassin, J., Marcus, H. R., Shafie, N. A., & Mohammed, N. F. (2023). Dynamic relationship between energy efficiency, health expenditure and economic growth: in pursuit for SDGs in Malaysia. International Journal of Ethics and Systems, 39(3), 594-611.

27.  Mounia, A., Yassine, H., & Hocine, I. Z. H. (2024). Literature Review on Cost Management and Profitability in E-Supply Chain: Current Trends and Future Perspectives. In 2024 IEEE 15th International Colloquium on Logistics and Supply Chain Management (LOGISTIQUA) (pp. 1-6). IEEE.

28.  Oflaz, N. K. (2019). Using smart contracts via blockchain technology for effective cost management in health services. Blockchain Economics and Financial Market Innovation: Financial Innovations in the Digital Age, 423-449.

29.  Potrafke, N. (2010). The growth of public health expenditures in OECD countries: do government ideology and electoral motives matter?. Journal of health economics, 29(6), 797-810

30.  Shahsvarzehi Narouei, R., Rahnamay Roodposhti, F., & pourzamani, Z. (2023). Provide a cost management model: with an efficiency approach. International Journal of Finance & Managerial Accounting, 8(30), 201-216. doi: 10.30495/ijfma.2022.62770.1712

31.  Tariq, M. U. (2024). Revolutionizing Health Data Management with Blockchain Technology: Enhancing Security and Efficiency in a Digital Era. In Emerging Technologies for Health Literacy and Medical Practice (pp. 153-175). IGI Global.

32.  Wenhua, Z., Qamar, F., Abdali, T. A. N., Hassan, R., Jafri, S. T. A., & Nguyen, Q. N. (2023). Blockchain technology: security issues, healthcare applications, challenges and future trends. Electronics, 12(3), 546.

33.  Xu, X., Wang, Q., & Li, C. (2022). The impact of dependency burden on urban household health expenditure and its regional heterogeneity in China: based on quantile regression method. Frontiers in public health, 10, 876088.

34.  Zhiping, Z. (2024). The Application of Blockchain Technology in Enterprise Value Chain Cost Management [J]. Pacific International Journal, 7(1).