Bakhtiari A, Jahanmehr N, Izadi R. Identifying the Priorities of Coverage of Preventive Services by Insurance Organizations in the World Health Systems. Iran J Health Insur 2021; 4 (2) :84-105
URL:
http://journal.ihio.gov.ir/article-1-189-en.html
1- National Center for Health Insurance Research, Tehran, Iran
2- Health Economics, Management and Policy Department, Virtual School of Medical Education & Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran , n.jahanmehr@gmail.com
3- Management and Policy Department, Virtual School of Medical Education & Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract: (4152 Views)
Introduction: The increasing costs of health care systems will be reduced significantly if preventive services are developed at levels of prevention. The experience of countries in the world in using preventive services and raising awareness of the related benefits can play a motivating role among the stakeholders in implementing such a policy in Iran. This study aimed to identify the most critical interventions covered by insurance organizations active in the world's health systems.
Methods: This study is a systematic review of studies related to a diverse range of preventive services in the health system and insurance organizations and provides evidence-based information on the benefits of developing this category of services and interventions. The study was done by defining the search keywords in the main database between December 30, 2004, to January 2019, carried out in 2020.
Results: Different categories of disease prevention services are being offered around the world that has brought significant benefits to communities. Among the most important benefits of developing such services are reducing costs, reducing health inequalities, increasing quality of life, and higher job productivity. In addition, different groups in the community, such as specific occupations or specific age and gender groups, while having specific preventive services, have developed their insurance policies that provide related preventive services. Therefore, insurance organizations play an essential role in the benefit and effective coverage of preventive services in communities, which has made the possibility of a person with insurance to use preventive services far more than people without insurance or with treatment-oriented insurance.
Conclusion: The benefits of preventive services in the world health systems have been proven, and some countries have adopted a law requiring the provision of such services to insurance organizations. On the other hand, insurance companies are facing increasing health costs, which has led the attention of policy makers of insurance companies to control costs. With the relevant evidence documented, it is time to move to preventive services.
Type of Study:
Systematic Review |
Subject:
Special Received: 2021/04/24 | Revised: 2021/09/26 | Accepted: 2021/09/14 | ePublished: 2021/09/19