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Showing 5 results for Effatpanah
Necessity of neuronavigation tariffing in neurosurgery in health insurance
Alireza Namazi Shabestari, Mohammad Effatpanah, Leila Ghamkhar,
Volume 5, Issue 4 (12-2022)
Abstract

Developing an Insurance Package for Pelvic Floor Muscle Rehabilitation Services After Childbirth in Order to Reduce Surgery Costs in the Long Term
Maryam Ghamkhar, Mehdi Rezaee, Mohammad Effatpanah, Alireza Namazi Shabestari, Leila Ghamkhar,
Volume 6, Issue 1 (Spring 2023)
Abstract
This article has no abstract.
Investigating the Effect of Daroyar Plan on Indicators of the Number and Cost of Drug Prescriptions in Iran
Leila Ghamkhar, Mohammad Effatpanah, Mehdi Rezaee, Sepideh Mirsalehi, Keyvan Tajbakhsh, Fatemeh Hajialiasgari,
Volume 6, Issue 2 (Summer 2023)
Abstract
Introduction: Daroyar project was implemented with the aim of regulating fair and sustainable access of people to medicines and increasing insurance coverage. This study investigated the effect of the plan on the number of prescriptions and the cost of the health insurance organization.
Methods: This study is a cross-sectional retrospective study. The research community is the outpatient electronic prescription of drugs of Iranian health insurance organization in the second 6 months of 1400 and 1401. In this study, the number of drug prescriptions, the cost paid by the insurance organization, and the number of service-providing pharmacies were extracted from the prescription dashboards of the Health Insurance Organization's electronic system. Data analysis was done using Excel 2019 software.
Results: The number of prescriptions increased by 71% and costs by 251% in 1401. The average cost increased by 105%, but the average number of prescriptions, excluding preferred currency, decreased by 12%. The preferred currency share of the total cost paid by the organization for electronic drug prescription was 57%. The highest cost paid by the organization was to Tehran province (13%). The amount of preferred currency has been increasing from October to March.
Conclusion: The Daroyar project has led to the improvement of people's access to pharmaceutical services. The decrease in the average net share of the organization per prescription is a sign of the coverage of cheap drugs. The significant share of the preferred currency indicates the success of the project in providing domestically produced drugs.

Performance Evaluation Indicators of Iran Health Insurance Organization Based on Macro Policies
Efat Mohamadi, Ahad Bakhtiari, Mohammad Mehdi Nasehi, Mohammad Effatpanah, Mehdi Rezaei, Zahra Shahali, Amirhossein Takian, Alireza Olyaeemanesh,
Volume 7, Issue 1 (Spring 2024)
Abstract
Introduction: The performance evaluation of the Iranian Health Insurance Organization (IHIO), considering the responsibilities, objectives, and duties outlined in the higher-level documents and laws, is an important issue that has received less attention. Given the importance of systematic monitoring and evaluation to facilitate planning based on overarching domestic policies, it is necessary to adopt a suitable approach to monitor programs and policies and to respond to higher-level authorities to fulfill assigned tasks. The present study aims to identify performance indicators for IHIO based on the analysis of relevant higher-level documents and laws.
Methods: This study was conducted qualitatively and based on content analysis of documents, policies, and executive activities related to monitoring the performance of IHIO, from the year the Universal Health Insurance Law of the country was passed (1373) until 1402, in the year 1402 (Solar Hijri calendar, equivalent to 2023/2024 Gregorian calendar). The Scott method was used to examine the validity of the documents, and qualitative content analysis and the deductive approach were employed to analyze the data.
Results: Nine policies related to monitoring the performance of the IHIO were identified, with 11 themes and total of 188-indicators identified as follows: Population indicators (8 indicators), National Health Accounts (NHA) (13-indicators), Covered population (25-indicators), Covered health services (19-indicators), Covered costs/financial participation status (11-indicators), Organization’s financial resources (26-indicators), Contracted centers (11-indicators), Cost trends, cost burden, and visit burden (23-indicators), Monitoring indicators (11-indicators), Operational efficiency of the organization (30-indicators), Access to services and health outcomes (11-indicators).
Conclusion: In order to conduct a thorough and comprehensive evaluation of the Iranian Health Insurance Organization's performance, which aims to enhance transparency and public trust in the organization, it is imperative to take into account a diverse range of indicators that encompass all operational and performance aspects of a health insurance entity. Additionally, national macro indicators, including population metrics and national health accounts, play a crucial role in this process. Failing to consider these indicators may lead to challenges and biases when assessing the organization's performance.

Estimating the Financial Burden of Psychological Counseling in Iran
Shahram Tofighi, Jahanara Mamikhani, Sedigheh Khadem, Mohammad Effatpanah, Mohammadjavad Kabir, Mehdi Rezaee,
Volume 7, Issue 2 (Summer 2024)
Abstract
Introduction: The burden of psychological disorders and its financial burden has increased in the world and in Iran. Usually, these patients need financial support to improve their mental health. Sometimes basic insurance organizations hesitate to include psychological counseling services in the insurance package. The assistance of the Welfare Organization and the Ministry of Health is not enough.
Methods: It is a descriptive study with financial calculations. Using the data of the Iranian Statistics Center, demographic information until 2031 and using the data of the mental health survey reports of the Ministry of Health in 2011 and 2021, the annual growth for the 90s was calculated. Then, with the discount formula, the growth of prevalence of disorders, different severity of disorders, the number of referrals to different centers, the number of referrals was estimated up to 2031. Assuming an annual tariff growth rate of 20%; The insurer's share is 30%, 50%, and 70%; 50% and 10% annual growth in the number of clients after providing insurance coverage, the estimate was completed
Results: The financial burden of insurance organizations for psychological counseling was estimated from 708.2 million tomans (insurance share 30% in 2024, fixed rate of clients) to 23,534 million tomans (insurance share 70%, annual growth of 10% clients in 2031).
Conclusion: Psychological counseling is both necessary and cost-effective to be covered by insurance organizations. By developing a right service package, psychological counseling can be covered according to the severity of the disorder, the location of the service provision, and the different shahres of the insurance organizations. It would be wise that some disorders, considered important, be covered by basic insurance organizations, for other cases supplementary insurance along with other supportive and welfare services such as subsidies would be rational.

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