Analysis of Current and Desirable Status of Iran\'s Basic Health Insurance
Background & Objctives: With regard to unclear government approach in the insurance sector, multiplicity of rules, high share of households, improper population coverage and lack of cost-effective interventions, this study aimed to analyze the current status of basic health insurance in Iran and...
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| Format: | Article |
| Language: | English |
| Published: |
Golestan University of Medical Sciences
2018-12-01
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| Series: | Jorjani Biomedicine Journal |
| Subjects: | |
| Online Access: | http://goums.ac.ir/jorjanijournal/browse.php?a_code=A-10-467-1&slc_lang=en&sid=1 |
| _version_ | 1811286787219259392 |
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| author | Roohollah Gholikhani Farbod Ebadi Fard Azar Mohammad Javad Kabir Mohammad Mehdi Tadayon |
| author_facet | Roohollah Gholikhani Farbod Ebadi Fard Azar Mohammad Javad Kabir Mohammad Mehdi Tadayon |
| author_sort | Roohollah Gholikhani |
| collection | DOAJ |
| description | Background & Objctives: With regard to unclear government approach in the insurance sector, multiplicity of rules, high share of households, improper population coverage and lack of cost-effective interventions, this study aimed to analyze the current status of basic health insurance in Iran and its distance from the desirable status according to upstream documents. In addition, we attempted to propose a strategy in this regard.
Methods: This qualitative research was performed in 2017 in four stages of analysis of the current status of upstream documents and laws, round-table discussions of policy-makers, and presenting political options. In total, 20 subjects were selected by targeted sampling method with maximum diversity and based on the saturation rule. Data were collected by document analysis and interviews with authorities. Moreover, data were analyzed applying content analysis and the deductive approach.
Results: The results were classified into five areas of population coverage, financial resources management, financial protection of insured individuals, strategic purchasing, policy-making, and structure. There was a significant distance between the desirable status based on upstream documents and laws and the current status. Recommendations: eliminating conflicts of interest in decision-making areas, complying with the public interest in making health decisions, observing the principles of the evaluation of regulatory effects, and assessing the economic and social effects of health decisions.
Conclusion: Despite the successful global experiences, the recommendations of the World Health Organization, and the existence of several optimal structures, proper models must be considered by the health system of the country through observing the relevant mechanisms and necessities. |
| first_indexed | 2024-04-13T03:06:02Z |
| format | Article |
| id | doaj.art-060ab13eb9ea4a98997fbd07600c34fd |
| institution | Directory Open Access Journal |
| issn | 2645-3509 |
| language | English |
| last_indexed | 2024-04-13T03:06:02Z |
| publishDate | 2018-12-01 |
| publisher | Golestan University of Medical Sciences |
| record_format | Article |
| series | Jorjani Biomedicine Journal |
| spelling | doaj.art-060ab13eb9ea4a98997fbd07600c34fd2022-12-22T03:05:13ZengGolestan University of Medical SciencesJorjani Biomedicine Journal2645-35092018-12-01645361Analysis of Current and Desirable Status of Iran\'s Basic Health InsuranceRoohollah Gholikhani0Farbod Ebadi Fard Azar1Mohammad Javad Kabir2Mohammad Mehdi Tadayon3 Department of public law, Faculty of law )campus(, Tehran University, Tehran,Iran Department of Health Services, School of Public Health, Iran University of Medical Science Department of Family and Community Medicine, School of Medicine Golestan University of Medical Sciences National Center for Health insurance Research. (NCHIR). Iran. Health Insurance Organization (IHIO) Background & Objctives: With regard to unclear government approach in the insurance sector, multiplicity of rules, high share of households, improper population coverage and lack of cost-effective interventions, this study aimed to analyze the current status of basic health insurance in Iran and its distance from the desirable status according to upstream documents. In addition, we attempted to propose a strategy in this regard. Methods: This qualitative research was performed in 2017 in four stages of analysis of the current status of upstream documents and laws, round-table discussions of policy-makers, and presenting political options. In total, 20 subjects were selected by targeted sampling method with maximum diversity and based on the saturation rule. Data were collected by document analysis and interviews with authorities. Moreover, data were analyzed applying content analysis and the deductive approach. Results: The results were classified into five areas of population coverage, financial resources management, financial protection of insured individuals, strategic purchasing, policy-making, and structure. There was a significant distance between the desirable status based on upstream documents and laws and the current status. Recommendations: eliminating conflicts of interest in decision-making areas, complying with the public interest in making health decisions, observing the principles of the evaluation of regulatory effects, and assessing the economic and social effects of health decisions. Conclusion: Despite the successful global experiences, the recommendations of the World Health Organization, and the existence of several optimal structures, proper models must be considered by the health system of the country through observing the relevant mechanisms and necessities.http://goums.ac.ir/jorjanijournal/browse.php?a_code=A-10-467-1&slc_lang=en&sid=1Basic Health InsuranceUpstream DocumentsCurrent StatusDesirable Status |
| spellingShingle | Roohollah Gholikhani Farbod Ebadi Fard Azar Mohammad Javad Kabir Mohammad Mehdi Tadayon Analysis of Current and Desirable Status of Iran\'s Basic Health Insurance Jorjani Biomedicine Journal Basic Health Insurance Upstream Documents Current Status Desirable Status |
| title | Analysis of Current and Desirable Status of Iran\'s Basic Health Insurance |
| title_full | Analysis of Current and Desirable Status of Iran\'s Basic Health Insurance |
| title_fullStr | Analysis of Current and Desirable Status of Iran\'s Basic Health Insurance |
| title_full_unstemmed | Analysis of Current and Desirable Status of Iran\'s Basic Health Insurance |
| title_short | Analysis of Current and Desirable Status of Iran\'s Basic Health Insurance |
| title_sort | analysis of current and desirable status of iran s basic health insurance |
| topic | Basic Health Insurance Upstream Documents Current Status Desirable Status |
| url | http://goums.ac.ir/jorjanijournal/browse.php?a_code=A-10-467-1&slc_lang=en&sid=1 |
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