Designing a national framework for preventing fraud in Iran's health system: a sequential mixed-methods study using qualitative analysis and Delphi consensus.

ABSTRACT:

Objectives

To design and validate a comprehensive, expert-informed national framework to prevent and control fraud and misconduct in Iran's health system. Fraud in this context refers to practices such as false claims, overbilling, unnecessary prescriptions, informal payments and beneficiary manipulation, which undermine efficiency and trust.

Design

A sequential mixed-methods study, including an exploratory qualitative phase followed by a two-round Delphi consensus process.

Setting

National-level study across multiple sectors of Iran's health system, including insurance, governance and health policy institutions.

Participants

In the qualitative phase, 12 experts (senior managers, auditors and policymakers) were interviewed, achieving data saturation. In the Del

SUBMITTER: Vafaee Najar A 

PROVIDER: S-EPMC12636870 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature