Showing 22 results for Type of Study: Review Article
Ezzatollah Gol-Alizadeh, Amir Pirouzian, Mohammad Reza Jabbari,
Volume 1, Issue 1 (7-2018)
Abstract
The growing diversity of health services, which often costs a lot, and the inability of governments to provide benefits to citizens. in all areas of health, clearly show the need for the presence and development of complementary health insurance in the health market. Private supplementary health insurance is usually provided in bulk, voluntarily, and extendable until the end of life. The purpose of this study was to provide solutions to improve the quality of complementary health insurance services and reduce government dependence. The supplementary health insurance function dedicate the second rank of the nongovernmental insurance market also, with the growth of 34.6% is the second highest growth rate in 2015. The coefficient of damage in this sector with 86.1% indicates its profitability in this year. By reviewing the patterns and models presented in the studies, in order to improve the level of health and complementary insurance, solutions were presented in 20 clauses. According to the present study, it is recommended to offer various insurance packages considering the age, gender, health status of individuals, geographical status, literacy level, income level, employment status etc.
Kioomars Ashtarian, Manal Etemadi,
Volume 1, Issue 3 (12-2018)
Abstract
The fourth industrial revolution that is currently taking place requires policy decisions and responses. Political will, as one of the important variables studied in public policy, is the subject of this paper. The management will requires that policymakers first become familiar with the knowledge, appropriate to the various dimensions of this revolution and have policy concern about it; Secondly, They should have the ability to formulate this policy discourse in the country’s managerial body and thirdly, they must develop the ability to spread this discourse in the community level. This paper, analyzing upstream documents and health policy-makers discourse, shows that such three conditions have not been yet met.
Iravan Masoudi Asl, Mohammad Bakhtiari Aliabad, Ali Akhavan Behbahani, Maryam Rahbari Bonab,
Volume 1, Issue 4 (2-2019)
Abstract
Introduction: Today, growing increase of costs is one of the challenges for health systems. The purpose of this study is to investigate the health costs trend in Iran and the policies adopted to manage them better.
Methods: This descriptive-analytic study was carried out in two steps: 1- General review of the Iran's health system costs trend based on National Health Accounts. 2-identification of Experts views on factors lead to increasing health costs in Iran and the strategies used to manage these costs better in last few decades, through simple and accessible sampling and semi-structured interviews. Data analysis was done through deductive / inductive hybrid framework, and a thematic framework was developed during the analysis. The NVivo software was used to manage and categorize data.
Results: health costs in Iran has increased over the past years, and various strategies have been used to manage these costs that Extending primary health care, expanding insurance coverage, implementing a family physician program in small towns, villages and among nomads are the most important ones.
Conclusions: Despite the adoption of some strategies to control the health costs in Iran in different periods, growing increase in health costs is a concern. Therefore, health policy makers need to make and implement appropriate polices in order to manage these costs better, while improving access, quality of service and eventually welfare of patients.
Saeed Heydari, Maryam Seyed-Nezhad, Mohammad Moradi-Joo,
Volume 1, Issue 4 (2-2019)
Abstract
Introduction: The design of a benefit package is a key tool for directing health systems to the universal health coverage. Deciding on service prioritization takes into account information on cost-effectiveness, the impact of financial protection, and equity in access to services. To this end, health technology assessment (HTA), which has legal backing and evidence-based protocols, can be used. Therefore, this study aimed to determine the role of health technology assessment in the package of designing.
Methods: This review study has been used to collect and analyze the available evidence. The search was conducted to identify related studies in the electronic database (Cochrane Library, Scopus, PubMed, Trip and Google Scholar) without any time limit and by August 2018 with proper keywords and strategies for each database.
Results: Out of the 132 articles studied, only 2 studies were selected according to inclusion and exclusion criteria. These two studies describe the experience of Thailand and the Netherlands in the role and application of health technology assessment in determining the benefits package. The Thai study describes the hierarchy and sequence of how to determine the choice of services to be included in the benefits package, and in the Dutch study, it refers to the policy and implementation levels and the infrastructure needed to establish a health technology assessment system to determine the benefits package.
Conclusions: Given the advancement of technologies (drugs, equipment, and diagnostic tests), cost growth and the lack of resources in the health system, it is suggested to select a benefit package focusing on health technology assessment studies. HTA is useful for informing health system decision makers about package coverage because it increases transparency, participation and accountability in the process. Accordingly, a 5-step model is recommended to determine the benefits package.
Peyman Rezaei, Afsoon Asadzadeh,
Volume 2, Issue 2 (9-2019)
Abstract
Introduction: The use of appropriate health payment system is one of the priorities for all countries. The aim of this study was to survey the features of diagnosis related groups (DRGs) and ambulatory payment classifications (APCs) in order to provide a framework for calculating inpatient and outpatient care costs in Iranian hospitals.
Methods: This review article conducted by searching bibliographic databases including PubMed،Science direct, SID and Cochrane library. Google scholar and other relevant websites were also searched. Studies restricted to English and Persian language. There was no study design and date limitation.
Results: Of all retrieved studies, 108 studies were selected. Seven DRGs systems have been developed primarily for inpatient services that had various elements for determining payment and were made to address particular limitations in the original DRGs. Different countries often have used their native inputs such as ICD clinical codes. DRGs approaches are converted the clinical code to the financial for determining costs. Finally, Payments for each condition or diseases are estimated based on Adjustment factors, Expenditure ceiling, and Cost weights set. In the APC system would be assigned specific current procedure terminology and ICD clinical codes for each patient who visited the physician and had procedures perform. The APCs approaches are converted the clinical code to the financial for determining costs. Finally, Payments for each condition or diseases are estimated based on Adjustment factors, Expenditure ceiling, and Cost weights set.
Conclusions: Using well-defined prospective payment systems such as native DRG and APC which cover inpatient and outpatient service costs are considered as an effective step in reforming Payments in Iran health care system
Moslem Sharifi, Jalal Saeidpour, Mohammad Javad Kabir,
Volume 3, Issue 1 (4-2020)
Abstract
Health insurance literacy is a fledgling concept that emerged largely after the Obama Care law in the United States. This study, through a narrative approach and by examining related literature, discusses various aspects of this concept and the definitional and instrumentation requirements in this field for other countries, including Iran. What is certain, given the substantial differences in the US health insurance system with other countries, any use of this concept and its operationalization requires the redefinition of a native and applicable insurance system and an effort to understand its operation to complement coverage. It has health insurance.
Sara ٍٍemamgholipour, Mobarakeh Alipanah Dolatabad, Pedram Nourizadeh Tehrani,
Volume 3, Issue 2 (8-2020)
Abstract
Introduction: Achieving the universal health coverage in each country is different according to cultural, social, economic conditions, available resources and development infrastructure, which in Iran over the past few decades, several efforts have been made in this field. The aim of this study is to gain successful experiences of countries such as Malaysia, Thailand, Chile, Costa Rica, Cuba, Sweden and some countries in different continents with different health care systems that have achieved universal health coverage.
Methods: This study is a review study. The bulk of the data studied is related documentation, including official published reports, articles, books, regulations, and newsletters that search for keywords such as insurance, universal health coverage, and health. Health, Health System, Financial Resources and Health System Performance in external databases such as Google Scholar, Web of Science and websites such as World Bank, World Health Organization, Also, the use of some internal databases such as Iranmedex and holding meetings with the beneficiaries of the Ministry of Health in Iran has been obtained. All data were analyzed by using content analysis method.
Results: Today, there is no single global model for designing health insurance systems. Countries differ in terms of priorities, population covered, degree of development, type of government system and other factors, and each has its strengths and weaknesses. Countries must evaluate these strengths and weaknesses with their economic, political, and executive priorities, needs, and constraints, and select the best system.
Conclusion: Successful countries in the field of universal health coverage have also benefited from the political and financial commitments of their government and the private sector has acted as a complement to the public sector. Recognizing the health needs for a regular and coordinated referral system is one of the reasons for improving public health coverage. Universal health coverage is a time-consuming process that Iran has come very close to this great goal in the past few years with the implementation of the Health Transformation Plan.
Beitollah Jafari, Kheirollah Parvin, Mohammad Sadeghi,
Volume 3, Issue 2 (8-2020)
Abstract
The present study explains and examines the role of sustainable economy development on the insurance industry and health with a case study of public and private health insurance in the Iranian legal system; Also, it pays attention only to the issue of health insurance and avoids entering into other aspects of social security and welfare, and intends to review the appropriate criteria for the implementation of basic health insurance in order to achieve universal insurance coverage and be assessed on the basis of priority. Paying attention to these areas, especially in developing countries, which face widespread resource constraints on the one hand and widespread health needs on the other, can strengthen organizational rationalism and planning and achieve greater resource utilization. The results of the present study indicate that cooperation between influential institutions is of great importance in the implementation of health programs. Another example of the impact of institutions on health is the international insurance coverage program. Another way is to attract private sector investors to the health sector. In Iran, the implementation of the Health Transformation Plan, if sustainable financial resources are developed, in addition to increasing patient satisfaction with public hospital services, can improve the quality of health services.
Nasrin Hozarmoghadam, Mitra Ghanbarzadeh, Asma Hamzeh, Maryam Ghafoorboroojerdi,
Volume 3, Issue 3 (10-2020)
Abstract
Global outbreak of the coronavirus since late 2019, has had a significant impact on the global economy and in this way has affected the insurance industry regarding its role in risk management and compensation for effects of such crises. Among these, according to the direct and indirect effects of the pandemic on people’s health and livelihood, three types of insurance namely life, health and travel insurance can be considered as susceptible sectors of the insurance industry to the current crisis, which strengthens the need for research in this field. In this regard, using the descriptive exploratory qualitative research, it is shown that the coronavirus can impact on life insurance through various channels such as increase in the death risk, sale and surrender of life insurance, underwriting process and financial aspects; and on health insurance through employers' insurance costs, medical expenses, demand for new medical services and special insurance policies, as well as changes in health insurance rates. Furthermore, COVID 19 pandemic can influence on travel insurance through travel reduction, change in loss and sale market, change in demand for coverage of travel insurance, change from registration of policy sale to registration of request for change of travel date, renewal of travel insurance and change in travel insurance distribution channels.
Reza Kiani,
Volume 4, Issue 3 (12-2021)
Abstract
Introduction: The status of coverage of pension funds and institutions for the support of the elderly, which is effective in promoting the health and social welfare of the elderly, their families and society as a whole, is one of the important issues in geriatrics. The desirable and effective benefit of this coverage for citizens is one of the characteristics of an advanced society and the birth of extensive changes in the development system of the countries. The purpose of this study is to identify the status of insurance pension coverage and support services for the elderly in different regions of the world in order to identify and compare the regions with the highest and lowest levels of this coverage.
Methods: The present study is a review study. The required statistics and information have been obtained through library and documentary methods and with reference to the statistical reports of the International Labor Organization and the World Social Security Union.
Results: The highest rate of coverage in 2019 was in North America with 100% coverage and the lowest was in sub-Saharan Africa with 22.7% of insurance coverage and support for the elderly.
Conclusion: The results show a significant increase in the status of insurance coverage and support for the elderly, especially in recent years. A condition that has been upgraded from a low level of coverage to a high level. However, insurance coverage and support for the elderly are not the same all over the world, and there are many differences.
Mohammad Mehdi Kiani, Khatereh Khanjankhani, Hajar Haghighi, Azam Raoofi, Efat Mohammadi, Alireza Olyaeemanesh, Amirhossein Takian,
Volume 4, Issue 4 (3-2022)
Abstract
Introduction: Health is one of the main dimensions of social policies that governments adopt with the aim of reducing social inequalities. The economic and political structure in Iran has made the importance government's approach play a more important role in determining health policies. The present study aimed to identify the reforms, laws and policies adopted by the Iranian health system after the Islamic Revolution and the impact of each on the functions of the health system.
Methods: This is a review study that identified the policies of the Iran health system between 1357 and 1399. Data collection was done by manual search on the websites of the relevant organizations. The documents were selected based on Jupp's four dimensions, and 101 documents were finally included. To classify the documents, the six-building block framework of World Health Organization was used.
Results: The findings of this study are categorized according to the approved policies in the field of health in the 3rd to 12th governments after the Islamic Revolution. Of the 26 policies approved during the years 1360 to 1368 and 31 policies approved from 1369 to 1376, the most cases were related to the service delivery dimension. However, the policies related to governance and leadership had the highest number among the 29 policies approved during the years 1377 to 1384 and 11 policies approved during the years 1385 to 1392.
Conclusion: An overview of the five periods of the development program shows that the attention of health policymakers has shifted from service delivery to governance and leadership; Meanwhile, other functions, especially the health information system, have been neglected during the years 1385 to 1395.
Manal Etemadi, Saeed Shahabi, Mahan Mohammadi,
Volume 4, Issue 4 (3-2022)
Abstract
Introduction: Given the high expenditure of universal long-term care for elderly and the challenge of financing it for most countries, this article intends to examine leading countries to provide solutions for Iran.
Methods: The present study is a comparative study using domain review and examines the evidence related to the insurance for long-term care in the selected countries in six dimensions: type of insurance, type of membership, contribution rate / premium, inclusion criteria for coverage, the scope of services covered, and ultimately cost sharing through studies reviewed in the electronic databases.
Results: The results in the six countries showed that long-term care insurance requires public sector support in full or partly in combination with the private sector. This insurance’ being consistent with basic insurance coverage, its mandatory nature, the combination of government and individual financing (deduction from salaries or taxes) and the existence of a limited user fee to receive services, have saw in all these countries. The type of coverage is defined either universally or only for the elderly, and finally the scope of services in these insurances is graded based on the degree of dependence, the time required and the place of receiving the service.
Conclusion: In all studied countries, compulsory insurance coverage for long-term care was designed to allow for cross-subsidization. Consolidation and reduction of fragmentation of resources and expansion of integrated risk sharing is an important prerequisite for designing long-term care insurance in Iran. It is necessary to implement of the law requiring supplementary insurance to only cover services outside the basic insurance package and redesign both the basic and complementary insurance packages to determine what can be defined in the form of long-term care insurance package.
Seyed Morteza Alizadeh Razavian,
Volume 5, Issue 1 (3-2022)
Abstract
The limitation of resources in the face of the unlimited needs of society is the origin of economic decisionmaking. The characteristics of health needs and the economic situation and service delivery system have led to the development of different models in prioritizing needs and providing resources for health needs. Knowing the patterns can help you choose the right method. In the UK, Canada, Sweden and Chile the structure is tax-based. The structure in Germany and Turkey is based on two pillars, tax and premium. In the United States, with the exception of government-funded people with disabilities, the rest of society uses private insurance. Sri Lanka, Malaysia and Brazil were forced to provide universal health coverage through tax revenues. Low-income countries are in the same group. In Thailand, Mexico and Kyrgyzstan, premiums from official employees, along with tax revenues, are the basis for the general population's access to health services. In developing countries, financing is mainly through out-of-pocket payments, but due to the injustice created, they are moving to rely on tax resources. In developed countries, the private sector is growing gradually, and even governments with national medical systems have allowed out-of-pocket payments to increase. Financing is related to the level of economic development. In countries with low per capita incomes, high informal employment rates, and unfair wealth redistribution, tax regimes work better. A variety of other methods, such as labeled taxes, special duties, and bond sales, can help provide better financial resources for health.
Zohreh Shahbazi, Karam Habibpour Gatabi, Mostafa Azkia,
Volume 5, Issue 3 (10-2022)
Abstract
Despite the impact of theoretical approaches explaining the concept of social security on the social security system, often in Iran, this concept does not have an independent status in sociological analysis and its theoretical analysis is reductionist and is usually considered as an economic concept. After reviewing and explaining the existing theories, the formation of theories was presented based on the three models of welfare state, good governance and governmantality. Their review reveals differences around the two issues of perceiving the power and purpose of social security. In the approaches of welfare state and good governance, power is understood in a structuralist, non-historical and hierarchical way. It is responsible for the implementation of social security programs But in the governance approach, it is understood as a special way of exercising power and governing over oneself and citizens to optimize living standards.Also, the critical evaluation of these theoretical models implies that the approaches that have considered social security as a text and discourse, with a critical, historical and discourse approach, unveil the values, assumptions and ideological dimensions and political rationality of social security. And they have more explanation.
Irvan Masoudi Asl, Mohammad Moradi-Joo, Tayebeh Moradi,
Volume 5, Issue 4 (12-2022)
Abstract
Introduction: Evaluating the state of health financing of countries helps to check the efficiency of the health system and the optimal use of the limited resources of their health system. This study was conducted with the aim of reviewing health financing evaluation tools and the functional area of each of them so that more effective and efficient reforms can be applied in the path of achieving universal health coverage.
Methods: This study was a systematic review that used Scopus and PubMed databases and World Health Organization and World Bank databases to find tools and articles related to health financing evaluation. Articles and tools published in English have been reviewed without time limit. Data analysis was done by content analysis method.
Results: A total of 35 articles and 9 tools were included in the study. After a complete review, finally, 6 tools (national health accounts, health system assessment approach, health sector situation analysis, organizational assessment to improve and strengthen health financing, health system review, health financing progress matrix) were analyzed. And all of them were examined from 9 dimensions of health financing assessment.
Conclusion: In this study, the evaluation tools of health system financing were identified and their characteristics were stated. Among the health financing evaluation tools during the last few decades, the health financing progress matrix can provide a more complete and comprehensive road map to identify the dimensions and performance of the health system financing area in the path of achieving universal health coverage.
Rajabali Daroudi, Abdoreza Mosavi, Omid Emami, Ali Akbarisari, Amin Mohammadi,
Volume 5, Issue 4 (12-2022)
Abstract
In recent decades, due to the increasing health expenditures and resource constraints, the economic evaluation studies results have been increasingly used to prioritize health interventions and resource allocation in most countries, especially in high-income countries. Economic evaluation studies allow health system policymakers and decision makers, including physicians, to select the most appropriate intervention scientifically and systematically by comparing the costs and consequences of different treatment interventions. In Iran, The results of economic evaluation studies are used to decide on the arrival of new drugs in the country as well as insurance coverage for medical interventions since a decade ago. However, many researchers and clinical professionals still do not have enough information about the types of economic evaluation studies and the principles of conducting these studies. In this article, while defining economic evaluation studies, the difference between these studies and other studies in health sector is stated. Then the main types of economic evaluation studies including cost-effectiveness, cost-utility and cost-benefit are described and the differences between these methods are expressed. Finally, the general principles of conducting economic evaluation studies in the health sector are explained.
Understanding these principles and their implementation by researchers, while improving the quality of economic evaluation studies, provides the opportunity for policy makers and decision makers in health system to compare the results of these studies with each other and their findings to make decisions about the allocation of resources between different health interventions
Fatemeh Hajialiasgari, Ahmad Khanahmadi, Alireza Atashi,
Volume 6, Issue 2 (9-2023)
Abstract
Artificial Intelligence Chatbots (AIC), nowadays, are one of the most important topics in natural language processing which is able to communicate with humans using natural language. The purpose of using AIC is to facilitate user interaction with services, products or companies. The purpose of this study is to investigate the applications of AIC in Iran’s health system generally and Iran Health Insurance Organization in particular and to provide services to people in this way, including the investigation of AIC and its need in the provision of health care, the study of the significant aspects of the workflow of AIC for healthcare, the AIC features in this field, and identifying the significant applications and limitations of artificial intelligence chatbot for providing healthcare services. Purveying AIC services to individuals, such as insurance credit information as well as offering contracting party centers are some of benefits of AIC application in Iran Health Insurance Organization.
Saba Karimi, َali Akbari Sari, Ali Akbar Fazaeli, Amir Abbas Fazaeli,
Volume 6, Issue 2 (9-2023)
Abstract
Equitable financing is an important goal of health systems and protecting the financial risks of health care. Also, equitable financing of health is important both for improving the state of health systems and for achieving universal health coverage (UHC). In this study, with an overview has introduced the indicators of justice in health and the results of the indicators in this field have been examined in the country. The search for articles in the present study is of a review type that was conducted through search engines and databases within the range of 2002-2022. In order to identify the advantages and disadvantages of indicators showing justice in health financing, including out-of-pocket payment indicators, catastrophic health expenditures index, Kakwani index, concentration index and fair financial contribution index, a review of studies was used and the limitations and advantages of each index were extracted and compared. The results of this study showed that in terms of health equity index, the index of back-breaking health costs had the highest frequency in the studies. Each of the indicators had advantages and problems. Also, according to the numerous studies on the calculation of the health justice index, the existence of a health watchdog is necessary to monitor these indicators.
Mohammad Jafari, Kheirollah Parvin, Mohammad Sadeghi,
Volume 6, Issue 3 (12-2023)
Abstract
Health is one of the most basic needs of all humans, and the main function of the health system of any country is to provide services in this area. The purpose of this research was to answer the question of how health services are provided, by which institution and according to what principles. After the victory of the Islamic Revolution, the expansion of social security in the 29th principle of the constitution, based on the fact that all people enjoy the benefits of social security as a universal right, was put on the agenda. Based on this, the main institutions, organizations, institutions and funds in the fields of insurance, support and aid of this system were obliged to carry out their executive and business affairs in the field of production and provision of services and related legal obligations by means of contracts whose terms are proposed by the Ministry of Cooperatives. Work and social welfare and the approval of the Supreme Council of Welfare and Social Security will be assigned to brokerage institutions. Although in Iran’s legal system, various institutions are responsible for providing health services to different sections of the society, but the main institutions that provide insurance services are the Iran Health Insurance Organization and the Social Security Organization, and each of these organizations, according to the duties and obligations are responsible for providing health services in the community.
Dr Jahanara Mamikhani, Yousef Mahmoodi, Shahram Tofighi, Mohammad Javad Kabir,
Volume 6, Issue 4 (3-2024)
Abstract
The marginal cost of public funding (MCPF) is a key factor in resource allocation. It's also an important measure of financial stability, especially in public health. The MCPF shows how much one more unit of public spending (including taxation) changes household spending. It also shows how much it affects society's welfare and security. We can restructure the tax system to rely less on aggressive taxes. We can also add progressive taxes. These changes could reduce the MCPF and spread the tax burden across income deciles. This research, describing the many sides of this cost, talks about its impact on social costs and public health, which are less discussed. We investigated the impact of this cost on health care services. It also affects fairness in health and social costs. Researchers have proposed different methods to calculate MCPF. Osher suggested the simplest. It uses the average and median national income of countries. The cost factor is a number greater than 1. Since health projects are financed through taxes, it is necessary to multiply the project cost by MCPF. This applies to health care projects and economic evaluations. Considering the final cost can provide a more accurate estimate of budget and costs.