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Aryankhesal, Aidin 
ORCID: https://orcid.org/0000-0002-6695-227X, Bouzarjomehri, Hossein, Roknabadi, Esmaeil Hosseinzadeh, Mohammadibakhsh, Roghayeh and Arya, Neil
(2026)
More Patients or Healthier Populations? Institutionalised Conflict of Interest, Health System Governance, and Population Health.
International Journal of Health Policy and Management, 15 (1).
ISSN 2322-5939
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Abstract
Conflict of interest (CoI) in health systems is commonly viewed as an individual ethical issue but may also become institutionalised when governance arrangements align policy-making authority with professional or financial self-interest. Using Iran as an illustrative case, this article examines how institutionalised CoI can gradually shape policy priorities and distort health system missions towards provider-centred rather than population-centred goals, often without deliberate intent. A comparative analysis of health ministers’ professional backgrounds suggests substantial variation across countries in governance arrangements and leadership models. The article discusses how institutionalised CoI may contribute to policy distortions including persistent reliance on fee-for-service (FFS) payment, weakened gatekeeping, dual practice, and inadequate transparency, ultimately affecting healthcare utilisation, financial protection, and health system performance. Addressing these challenges requires governance reforms that strengthen leadership, align provider incentives with population health, and improve transparency, accountability, and institutional independence.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | conflict of interest,corruption,governance,health policy,health systems,iran,leadership and management,health(social science),health policy,management, monitoring, policy and law,health information management ,/dk/atira/pure/subjectarea/asjc/2900/2911 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > School of Health Sciences |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health) |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 06 Oct 2026 12:14 |
| Last Modified: | 06 Oct 2026 12:14 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/104731 |
| DOI: | 10.34172/ijhpm.10079 |
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