The Use of Evidence-Informed Deliberative Processes for Health Insurance Benefit Package Revision in Iran
Background Iran considers the revision of its health insurance benefit package (HIBP) as a means to achieve universal health coverage (UHC). Yet, its decision-making process has been criticised for being weak in terms of accountability and transparency. This paper reports on the development and imp...
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| Format: | Article |
| Language: | English |
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Kerman University of Medical Sciences
2022-11-01
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| Series: | International Journal of Health Policy and Management |
| Subjects: | |
| Online Access: | https://www.ijhpm.com/article_4219_883ee8c2568b5b32be43881b2073a2f2.pdf |
| _version_ | 1811158725461803008 |
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| author | Mojtaba Nouhi Rob Baltussen Seyed Sajad Razavi Leon Bijlmakers Mohammad Ali Sahraian Zahra Goudarzi Parisa Farokhian Jamaleddin Khedmati Reza Jahangiri Alireza Olyaeemanesh |
| author_facet | Mojtaba Nouhi Rob Baltussen Seyed Sajad Razavi Leon Bijlmakers Mohammad Ali Sahraian Zahra Goudarzi Parisa Farokhian Jamaleddin Khedmati Reza Jahangiri Alireza Olyaeemanesh |
| author_sort | Mojtaba Nouhi |
| collection | DOAJ |
| description | Background Iran considers the revision of its health insurance benefit package (HIBP) as a means to achieve universal health coverage (UHC). Yet, its decision-making process has been criticised for being weak in terms of accountability and transparency. This paper reports on the development and implementation of the HIBP revision in Iran in the period 2019-2021, employing evidence-informed deliberative processes (EDPs), a framework for benefit package design with the explicit aim of optimising the legitimacy of decision-making.Methods The High Council for Health Insurance (HCHI) is coordinating the HIBP revision: it planned the six steps of the EDP framework with support from World Health Organization (WHO) and Radboudumc in 2019, and conducted a pilot project on multiple sclerosis (MS) diagnosis and treatment in 2020.Results Implementation of the MS pilot project concerned the installation of advisory committees (involving some 60 stakeholders in supportive task forces, a technical working group [TWG] and a national advisory committee [NAC]), the selection of decision criteria (relating to quality of care, necessity, and sustainability), the inclusion of services for evaluation (nine in total), and the assessment and appraisal of these services.Conclusion Implementation of the priority setting process for MS diagnosis and treatment services has likely improved the legitimacy of decision-making by involving stakeholders who engaged in deliberation based on available evidence in a stepwise, transparent process. It is expected to improve the quality of care for MS patients as well as its financial accessibility, at a zero net budget impact. The pilot project has served to help Iran’s health system move faster toward UHC for a broader range of essential health services. |
| first_indexed | 2024-04-10T05:27:53Z |
| format | Article |
| id | doaj.art-5a7aa18f964d467eab77e8cca54c0d5b |
| institution | Directory Open Access Journal |
| issn | 2322-5939 |
| language | English |
| last_indexed | 2024-04-10T05:27:53Z |
| publishDate | 2022-11-01 |
| publisher | Kerman University of Medical Sciences |
| record_format | Article |
| series | International Journal of Health Policy and Management |
| spelling | doaj.art-5a7aa18f964d467eab77e8cca54c0d5b2023-03-07T09:11:55ZengKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59392022-11-0111112719272610.34172/ijhpm.2022.64854219The Use of Evidence-Informed Deliberative Processes for Health Insurance Benefit Package Revision in IranMojtaba Nouhi0Rob Baltussen1Seyed Sajad Razavi2Leon Bijlmakers3Mohammad Ali Sahraian4Zahra Goudarzi5Parisa Farokhian6Jamaleddin Khedmati7Reza Jahangiri8Alireza Olyaeemanesh9National Institute for Health Research, Tehran University of Medical Sciences, Tehran, IranRadboud University Medical Centre, Nijmegen, The NetherlandsMofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IranRadboud University Medical Centre, Nijmegen, The NetherlandsMultiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IranHealth Human Resources Research Center, Department of Health Economics, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, IranHigh Council for Health Insurance, Ministry of Health and Medical Education, Tehran, IranPharmaceutical Management and Economics Research Center, Tehran University of Medical Sciences, Tehran, IranHeath Management and Economics Research Center, Iran University of Medical Sciences, Tehran, IranHealth Equity Research Center, Tehran University of Medical Sciences, Tehran, IranBackground Iran considers the revision of its health insurance benefit package (HIBP) as a means to achieve universal health coverage (UHC). Yet, its decision-making process has been criticised for being weak in terms of accountability and transparency. This paper reports on the development and implementation of the HIBP revision in Iran in the period 2019-2021, employing evidence-informed deliberative processes (EDPs), a framework for benefit package design with the explicit aim of optimising the legitimacy of decision-making.Methods The High Council for Health Insurance (HCHI) is coordinating the HIBP revision: it planned the six steps of the EDP framework with support from World Health Organization (WHO) and Radboudumc in 2019, and conducted a pilot project on multiple sclerosis (MS) diagnosis and treatment in 2020.Results Implementation of the MS pilot project concerned the installation of advisory committees (involving some 60 stakeholders in supportive task forces, a technical working group [TWG] and a national advisory committee [NAC]), the selection of decision criteria (relating to quality of care, necessity, and sustainability), the inclusion of services for evaluation (nine in total), and the assessment and appraisal of these services.Conclusion Implementation of the priority setting process for MS diagnosis and treatment services has likely improved the legitimacy of decision-making by involving stakeholders who engaged in deliberation based on available evidence in a stepwise, transparent process. It is expected to improve the quality of care for MS patients as well as its financial accessibility, at a zero net budget impact. The pilot project has served to help Iran’s health system move faster toward UHC for a broader range of essential health services.https://www.ijhpm.com/article_4219_883ee8c2568b5b32be43881b2073a2f2.pdfuniversal health coverageiranmultiple sclerosisbenefit packagedeliberative processesrevision |
| spellingShingle | Mojtaba Nouhi Rob Baltussen Seyed Sajad Razavi Leon Bijlmakers Mohammad Ali Sahraian Zahra Goudarzi Parisa Farokhian Jamaleddin Khedmati Reza Jahangiri Alireza Olyaeemanesh The Use of Evidence-Informed Deliberative Processes for Health Insurance Benefit Package Revision in Iran International Journal of Health Policy and Management universal health coverage iran multiple sclerosis benefit package deliberative processes revision |
| title | The Use of Evidence-Informed Deliberative Processes for Health Insurance Benefit Package Revision in Iran |
| title_full | The Use of Evidence-Informed Deliberative Processes for Health Insurance Benefit Package Revision in Iran |
| title_fullStr | The Use of Evidence-Informed Deliberative Processes for Health Insurance Benefit Package Revision in Iran |
| title_full_unstemmed | The Use of Evidence-Informed Deliberative Processes for Health Insurance Benefit Package Revision in Iran |
| title_short | The Use of Evidence-Informed Deliberative Processes for Health Insurance Benefit Package Revision in Iran |
| title_sort | use of evidence informed deliberative processes for health insurance benefit package revision in iran |
| topic | universal health coverage iran multiple sclerosis benefit package deliberative processes revision |
| url | https://www.ijhpm.com/article_4219_883ee8c2568b5b32be43881b2073a2f2.pdf |
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