Showing 81 results for Mohammad
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.
Mohammad Darijani,
Volume 1, Issue 1 (7-2018)
Abstract
Introduction: Coronary artery disease (CAD) is the Non-contagious leading cause of mortality worldwide, as more than 1 million heart attacks and strokes occur every year, of which about 30% of them die. The use of invasive methods such as angiography for the diagnosis of coronary artery disease has been reached with high costs due to the cost of this method and its complications, and on the other hand, non-invasive methods such as echocardiography is more cost-effective and has fewer side effects.
Methods: This descriptive retrospective cross-sectional study was performed in selected hospitals in Yazd in the second six months of 2014. All cases were collected from patients admitted for angiography and echocardiography, and in total 1801 records/files were submitted for examination.
Results: Assessment of patient’s records indicated, the echocardiography results in 38% of patients and exercise test results in 30% of the patients and the result of the angiography in 72% of patients, were abnormal .
Conclusions: The results showed that, 38% of the echocardiographic results and 72% of the angiographic results were abnormal. Performing non-invasive tests, such as echocardiography and exercise testing, resulted in a loss of cost due to a small number of positive cases and also may cause an anxious in patients. This result has been shown more likely in women and young individuals.
Ali Shojaee, Seyed Mosoud Shajari Pourmosavi, Mohammad Mehdi , Reza Moradi, Sanaz Taghizadeh, Elnaz Kalantari,
Volume 1, Issue 1 (7-2018)
Abstract
Introduction: Health system reforms are designed and implemented according to the situational conditions of each country. Recently health reforms have focused on resources and costs in the health sector for governments; they would be as the tools for making the necessary changes and improvements. Governments have designed and implemented health reforms step by step to completing the coverage of health services in terms of geographic accessibility, service affordability, and avoiding health impoverishments, catastrophic poverty from the use of health services in recent two decades. Objectives other than completing public coverage, improving quality and the quality of health services and care, and the logical reduction in costs and the optimal use of resources. Objectives other than completing public coverage, improving quality The quality of health services and care has not had a reasonable reduction in costs and the optimal use of resources. Comparing the spending costs of hospitalization in the years before and after the Iranian Healthcare Reforms Plan in 2014 has could show that the efficiency and cost of spending. This study seeks to examine the average cost of each hospitalization case in the years before and after the Iranian Healthcare Reforms Plan to compare the impact of the costs on health insurance funds.
Methods: The present study was a cross sectional study. The population of the study has included the sum of the inpatient bed day of health insurers admitted in hospitals of in 31 provinces over the past 5 years from 2010 to 2015. In this study, survey was being conducted, and accessible data resources in the databases were used for data collecting process and analyzing. The analysis has been conducted by using Excel 2010.
Results: The highest of growth rate of the cost of inpatient bed day of health insurers in the first year of the Iranian Healthcare Reform Plan was Included respectively to the rural fund (88.4%), governmental employees fund (75.2%), self-employed fund (73.17%) and other populations fund (73.10%), and the self-employed fund shown third ranking in growth rate, although growth rate of the cost spending in all funds was more than 73%. In the first year of Iranian Healthcare Reform Plan has shown more inpatient costs growth rate than 73 percent’s for all the Iranian Health Insurance Funds.
Conclusion: The average of total inpatient spending cost has increasing trend in all funds of Iran Health Insurance and if there is not be a serious review of the Reform Plan, the health insurance organization may been faced serious financial problems. Therefore, by reviewing the Reform plan, it is possible to improve the plan as well as to ensure health insurance regarding sustainability of financial resources.
Efat Mohamadi, Taraneh Yousefinezhadi, Ali Hassanzadeh, Mojtaba Atri, Mohammadreza Mobinizadeh, Zahra Goudarzi, Sara Mohamadi, Alireza Olyaeemanesh,
Volume 1, Issue 3 (12-2018)
Abstract
Introduction: Implementation of the Health Transformation plan (HTP) has had many effects so far. The analysis of these impacts can help policymakers and planners to continuously improve the health system's ultimate goals. Considering that, health financing is one of the most impressive of health system functions from the HTP, the present study examines the effect of the HTP on supplementary health insurance as part of financial providers in the health system in Iran.
Methods: This is a descriptive study carried out using secondary data in 2017. Data were gathered using information systems of health insurance organizations and the statistical yearbook of central insurance of the country. Data analysis was performed using Excel and SPSS software. To analyze and report these data, descriptive statistics and analytical tests were used.
Results: The effect of the HTP on the share of health care providers has shown that in private financing, the share of households is the highest, and during the period 2002-2004, the average share of households from the total private sector share was 86.5%. During the period of 2002-2003, the share of the domestic government as the public sector was 54% on average. Findings in relation to supplementary health show that the net loss has been ascending and premium rate has been increasing.
Conclusions: The share of households in health expenditures has decreased since the implementation of the HTP, but the average pocket spending in the public and private sector has not decreased by more than 10%. The goal of creating competition and improving the quality of the public sector with the private sector and increasing the incentive for people to go to the public sector has largely been met by changing the frequency of contributions made by the financiers. In the long run, with the continuation of the implementation of the health system reform plan and the elimination of the way in which supplementary health insurers benefit from health subsidies, a high percentage of supplementary health insurance funds in the private sector is consumed, while it is better to adopt measures for the use of this resource in the public sector.
Mohammadreza Rezaee, Saeid Daei Karimzadeh, Mehdi Fadaei, Akbar Etebarian,
Volume 1, Issue 4 (2-2019)
Abstract
Introduction: The Iran Health Insurance Organization (IHIO) was established to develop the Iran Health Insurance Sector. Currently, this organization lacks the adequate funding and faces challenges in providing the required resources due to the imposed unilateral sanctions; therefore, it is necessary that this organization take proper measures within the framework of state policies regarding the resilience economy in order to finance itself and cover more population in accordance with the Iranian operating laws. The objective of the present study was to propose a financing model for the IHIO based on the resilience economy.
Methods: This was a qualitative study based on the Grounded Theory (GT), and the data were collected from framework documents, open and in-depth interviews, and a review of the lectures given by 31 experts. The validity was first examined by the interviewees and then approved by the experienced professors. The reliability was determined to be 73% via process auditing. The data were analyzed through a GT-based methodology and constant comparison over three stages of open, axial, and selective codings.
Results: The examination of the qualitative date revealed that there are many factors in action in the IHIO’s financing process and this organization needs to review and revise its structure and methodology. Taking into consideration the current sanctions and lack of funds, the IHIO should change the following seven components within the framework of notified resilience economy policies: organizational management, financial management, research, structural change, cultural revision, and regulatory procedures.
Conculsions: There has been a remarkable increase in the IHIO’s insured parties recently, and more people have been receiving healthcare services. Thus, it is highly essential to propose a model to change the IHIO’s approach towards commercialization and make it produce more revenues and finance in accordance with the current economic situation in Iran.
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.
Hassan Askarzadeh, Mohammad Jafar Tarokh,
Volume 1, Issue 4 (2-2019)
Abstract
Introduction: A significant amount of treatment cost is paid by health insurance organization. Insurance companies, mostly, use certified people to consider documents, but according to the number of documents and the limitation of time and human resource, consider documents carefully is almost impossible and more importantly, some infringements are not identifiable According to only one document but is identifiable by accumulation of documents and intelligent analysis based on data mining. Detection of beneficial referral (self-referral and kickback) that a doctor refers a patient to a specific pharmacy that has benefits for him, is one of these things.
Methods: In this research, data warehouse was prepared by using Tehran health insurance data until 1396 and then after eliminating faulty data, according to network mining methods, actions for detecting anomalistic referrals on the network, data filtering and weighing the edges of the network based on certified people views, were taken. This method was implemented in Knime environment and a short list was presented to health insurance organization’s monitoring department for considering.
Results: In this research, according to the importance of detected interactions during network mining‘s process between doctors and pharmacies, and using visual tools in Knime, 73 doctors were detected that had meaningful relation with 26 pharmacies.
Conclusions: Inspectors of health insurance organization can have a more accurate and more effective examination with spending less time and human resource according to examination patterns based on network mining and visualization.
Farzaneh Maftoon, Batool Mousavi, Mohammadreza Soroush, Kazem Mohammad, Mojgan Sharifan, Fatemeh Naghizadeh Moghari,
Volume 1, Issue 4 (2-2019)
Abstract
Introduction: The rate of out of pocket in health services has particular importance in health system. The aim of this study was to assess the rate of out of pocket and also the satisfaction with reimbursement process.
Methods: This study was across- sectional one which was done in 2018. At all 1177 war survivors and their families whom were covered by supplementary insurance were studied and they were selected randomly. In this study the questionnaire which was used in similar previous study, used for collecting data.
Results: At all 1177 veterans, their families and martyrs' families were studied. About 53 percent (622 persons) of them had paid out of pocket for health services during the one year. In reimbursement process the satisfaction of 622 studied persons with the waiting time, providers, service place and repayment process was 33%, 69%, 54% and 39%.respectively. Also the waiting time and situation of cost repayment effected on satisfaction with reimbursement process.
Conclusions: Base on this study results decreasing the rate of out of Pocket Payment and increasing the satisfaction with reimbursement Process are important. For next study it is recommended appropriate project resulted in strategies for improving reimbursement Process.
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.
Mohammadreza Rezaee, Said Daei-Karimzadeh, Mehdi Fadaei, Akbar Etbarian, Hamid Bahrami,
Volume 2, Issue 1 (6-2019)
Abstract
Introduction: The family physician program and the referral system in health insurance of Iranian villagers and nomads were implemented in 2005 by the Iran Health Insurance Organization, after being approved by the Islamic Consultative Assembly. Financial resources and other physical and legal infrastructures as well as human resources are the essential requirements for implementing this program. The present study aimed at examining the factors contributing to the success of this national program in the described areas, considering their ease, accessibility, and role in the success of the family physician program and the referral system in health insurance of Iranian villagers and nomads in 2017.
Methods: In the current study, the variables involved in the physical and legal infrastructures, manpower, and provision of financial resources were first examined using Delphi method according to the experts' opinion including practitioners involved in the rural programs, inspectors, and supervisors of health insurance plan as well as experts and managers of Khuzestan, Isfahan, Lorestan, Ilam, Kermanshah, Chaharmahal va Bakhtiari, and Kohgiluyeh va Boyer-Ahmad provinces selected based on the purposive and chain sampling methods. Student t-test was then used to compare the responses with standard tables.
Results: In the provision of financial resources, physical and legal infrastructure and manpower after several years of implementating the program were approved by the indices such as the timely allocation of funds and provision of service packages, the determination of the actual per capita and the payment of services per capita, approval of referral system law and upstream laws, the payment of franchises at levels 2 and 3, and the number of specialists in the villages, their appropriate distribution on the basis of population density and the expansion of health centers based on this density, appropriate training, and long-term contracts, which create a sense of usefulness and ease of using services in insures and has a significant relationship with changing the family physician program and the success of the project.
Conclusions: After several years of implementing rural family physician program, the project has a relatively appropriate performance in terms of financing and other infrastructures. However, the referral system is still not implemented properly and feedbacks from specialized physicians are not sent to family physicians.
Maryam Seyed-Nezhad, Mohammad Moradi-Joo,
Volume 2, Issue 2 (9-2019)
Abstract
Ali Ayoubain, Amir Ashkan Nasiripour, Seyed Jamaledin Tabibi, Mohammadkarim Bahadori,
Volume 2, Issue 2 (9-2019)
Abstract
Introduction: Evidence-based decision making plays an important role in the health system. Decision-making is based on observable results and real information, and it will naturally be easier to achieve the desired output. Therefore, this study aimed to identify and prioritize evidence-based decision making in health policy.
Methods: This is a descriptive-analytic study that was carried out in 2019. The population of the study consisted of all experts in the health system of Iran. Twenty people were selected through targeted sampling. The data gathering tool is a pairwise comparison questionnaire. Data were analyzed using Expert Choice Version 11 software.
Results: According to the findings of this study, external factors, data factors and evidence-based models with the highest weight of 0.649 have the highest weight. In addition, in internal factors, the IT factor with the weight of 0.415 have the highest weight. In general, data and evidence-based models and IT and IT have the highest weight and communication and trust respectively of 0.015 and 0.013, respectively, among the lower limitations of the number of factors derived from evidence-based decision-making methods in the field of health management.
Conclusions: The results of this study showed that a total of 10 structures in evidence-based decision making in the health system of Iran. Therefore the managers and policy makers can identify the best evidence and make the best decisions in an evidence-based decision-making process.
Masoud Ferdosi, Mohammad Amin Daneshvar,
Volume 2, Issue 2 (9-2019)
Abstract
Introduction: Trying to contain hospital costs is one of the biggest challenges facing the Iranian health system. In this study, we attempted to identify the key factors affecting hospital costs, hospital cost containment approaches, and to tailor intervention packages accordingly.
Methods: This study was conducted in three stages. In the first stage, by searching databases and expanding the total cost formula for a hospital from the health system perspective, key factors affecting hospital costs were identified. In the second stage, cost control approaches, intervention packages, and their prioritization criteria were identified in a panel of experts with the participation of 4 faculty members of the School of Management and Medical Informatics. In the third stage, the matrix scoring for intervention packages was completed and prioritized by 21 hospital managers.
Results: By expanding the formula of the total cost (C=P×Q), three factors of technology, productivity, and inflation in the Price field (P), and three factors of covered population, Utilization and overuse in the Quantity field (Q) were identified. For these key factors, 17 components were identified, which 9 components were intervenable. Then, based on expert panel members' opinion, 10 intervention packages were defined. These packages were prioritized by five criteria including: "effectiveness, appropriateness, feasibility, efficiency, and painlessness". Finally, the five most important intervention packages were selected as: "prevention of inappropriate use of services", "production of low-cost hospital services", "reducing inpatient costs", " containing drug costs" and " containing capital medical equipment costs" respectively.
Conclusions: Considering financing problems of the Iran health system, attention to cost containment approaches is very important especially from the health system perspective. This study showed that by identifying key cost factors and cost control approaches, special intervention packages could be formulated that are relatively painless and in line with upstream policies.
Masud Ferdosi, Mohammad Reza Rezayatmand, Maryam Barati,
Volume 2, Issue 3 (12-2019)
Abstract
Introduction: Proper tariff setting of health services in addition to reduction the health sector resources wastages, increases the healthcare providers’ incentives in delivering effective services. The purpose of this study was to identify the waste points of HTP hospital resources, and to offer some solutions in medical tariffs setting.
Methods: This is an original applied research conducted employing a content analysis method. In order to identify hospital resources wastages and cost control approaches, PubMed, Irandoc, SID, Google Scholar and Magiran databases were searched with keywords wastage- tariff- Health Transformation- Cost and Cost Control Plan. Related articles were extracted. The nominal group technique was used to classify the wastes, and a focus group discussion with 33 participatants of senior managers and experts of hospitals, insurance organizations and academic members of Isfahan University of Medical Sciences was used to confirm the solutions.
Results: The mos t important wastages caused by diagnostic and Therapeutic services tariffs were disparities in the income levels of some specialists, imbalances in the income of various specialist groups, imbalances in physicians’ earnings versus other medical personnel’s, and induced demand. The most important cost containment strategies included tariff review, reconstructing the health sector financial structures, and reinforcing accurate pricing, reducing induced demands, implementing family physician and referral systems, and tracing health services abuse.
Conclusion: The Iran HTP and any other reform plan in the health system will have its own costs, so that if the wasted resources are not identified and controlled, the success of the plan would be in danger.
Seyyedeh Fatemeh Sagha Abolfazl, Sara Emamgholipour, Mehdi Yaseri, Mohammad Arab,
Volume 2, Issue 3 (12-2019)
Abstract
Introduction: To achievement Universal Health Coverage, one of the target groups is refugees that have been provided basic health insurance for this population. The purpose of the present study was to compare the inpatient costs, in drugs, surgery, laboratory and other paraclinic, imaging, and resource allocation of inpatient costs and burden of inpatient in the two years before and after basic health insurance.
Methods: This study is a descriptive-analytic and applied type. The research environment was the university hospitals of Tehran province and the statistical population of the refugee hospitalization records during two years before and after the implementation of insurance. Cluster sampling was performed in two stages. At first, 55 hospitals of the province, 15 hospitals and then 1575 samples in each period, were randomly selected. Data were analyzed by SPSS.
Results: By implementation of basic health insurance, the average share of refugees from inpatient costs was 13.50% (P <0.001), the share of supplementary insurance was 0.04% (P <0.001), the share of hospital discounts was 9.99% (P <0.001). Burden of inpatient increased by 52% (P <0.001). The average share of drug and surgery costs decreased by P = 0.002 and P <0.001, respectively, and imaging services increased by P <0.001. Laboratory and other para clinics did not show a significant difference.
Conclusion: Basic health insurance reduced patient share and hospital discounts and increased burden of inpatient. However, given the low population coverage, it seems necessary to reconsider the dimensions of Universal Health Coverage, and especially population coverage.
Mohammad Reza Rohoullahi, Shahram Tofighi,
Volume 2, Issue 3 (12-2019)
Abstract
Mohammadreza Rezaee, Said Daei-Karimzadeh, Mehdi Fadaei, Akbar Etbarian,
Volume 2, Issue 4 (12-2019)
Abstract
Introduction: Having an insured population of 39 million, Iran Health Insurance Organization is one of the largest entities in health insurance sector of Iran. The organization needs to monetize in order to equate its resources with its costs due to economic conditions imposed on the country following sanctions as well as the aging trend of the society. That is, the organization needs to take appropriate measures to finance the coverage of health insurance for every Iranian, for which it is responsible in accordance with current law. This study aims at studying modern monetizing methods in Iran Health Insurance Organization.
Methods: First, the new monetizing methods were extracted using grounded theory and employing field’s experts’ opinion. Given the lack of finance experts in health insurance sector, the statistical population was consisted of 21 academic and administrative experts of health and insurance economy. Then the analytic hierarchy process was employed to analyze and rank findings.
Results: The nine main monetizing methods for Iran Health Insurance Organization were compared based on absorption rate, and revenue volume, sustainability, and endogeneity. According to the paired comparison matrix, the monetizing from individuals was ranked 1 with a weight of 0.314, internal monetizing was ranked 2 with a weight of 0.264, monetizing from subsidiaries was ranked 3 with a weight of 0.221, business
and non-insurance activities was ranked 4 with a weight of 0.209, training and knowledge transfer was ranked 5 with a weight of 0.199, funding from other organizations was ranked 6 with a weight of 0.188, receiving public funds was ranked 7 with a weight of 0.176, and public donations and other monetizing measures were ranked last with weights of 0.165 and 0.163, respectively. For monetizing from individuals, receiving direct payments from recipients of services revealed to be far more significant than other options including selling a variety of insurance policies, introducing complementary insurance, and selling services to regional customers.
Conculsions: Results show that the insured need to carry the main burden of health insurance costs. The government and other relevant agencies are no longer able to finance Iran Health Insurance Organization. This is somewhat different from what other researchers suggest. However, experts believe that the Health Insurance Organization should be financed by service recipients. In order to prevent too much pressure on the insured clients, the organization can take various measures, which are of equal significance to receiving direct fees from service recipients. These include selling various insurance policies, introducing supplementary insurance policies, and selling services to regional clients as an insurance and investment organization.
Mohammad Meskarpour-Amiri, Parisa Mahdizadeh,
Volume 2, Issue 4 (12-2019)
Abstract
Introduction: Investigating the effect of macroeconomic variables on health indicators can provide the ability to predict the effect of economic fluctuations on health in addition to health policy makers' awareness of the impact of economic variables on health level. The purpose of this study was to analyze the trend of the main variables of Iran's macroeconomics and their impact on Iran's health indicators.
Methods: The present study was a descriptive-analytical study. In this study, in order to identify the impact of economic fluctuations on public health, the trend of 4 decades (19712011-) fluctuation of macroeconomic and public health indices were analyzed. Health indicators were collected from the World Bank database and macroeconomic indicators from the Central Bank of the Islamic Republic of Iran and the Iranian Statistics Center. To identify the relationship between variables, the VAR model estimated and the Granger causality test used. Regression models and statistical tests run by using eviews7 econometrics software.
Results: The growth of "per capita income", "income inequality", and "unemployment rate" had statistically significant effect on life expectancy and mortality in children under 5 years (P <0.05) and Granger causality test also confirmed the effect. Although the "exchange rate disorder" had a statistically significant effect on life expectancy (P <0.05), its effect on mortality of children under 5 years was not significant (P> 0.05). Among macroeconomic variables, the effect of income inequality on health indicators was more than other variables.
Conclusion: Among macroeconomic variables, the effect of income inequality is larger and long lasting than other variables. By adopting income redistribution policies, the government can control the effects of economic fluctuations on the society's health through reducing income inequality.
Majid Akbari, Khalil Alimohamadzadeh, Ali Maher, Seyed Mojtaba Hosseini, Mohammadkarim Bahadori,
Volume 2, Issue 4 (12-2019)
Abstract
Introduction: Given the importance of health as a valuable asset and achieving universal health coverage, Enjoyment the benefits of health insurance are essential to achieving health for all. So identifying and analyzing the benefits of integrating health insurance funds can be an effective step in this regard. This study aimed to analyze the Systematic Relationship of Health Insurance Integration Benefits in Iran.
Methods: This descriptive study was conducted on 68 health insurance experts in two stages of systematic identification and analysis of the benefits of health insurance integration in Iran. Data collection tool was a 40-item Likert-type questionnaire in the Delphi phase and a paired comparisons questionnaire in the systematic analysis stage. Delphi phase analysis was performed using SPSS software and one-sample t-test and factor weighting were performed using FUZZY DEMATEL technique using MATLAB software.
Results: In total, 40 benefits were identified for integration of health insurance in Iran, and 29 benefits were accepted through Delphi phase. The results of Systematic Relationship Analysis also showed that the component of Stewardship with coordinates (1.31 and 1.31) as the most influential component and the component of operational processes with coordinates (0.959 and -0.959) as the most influential component.
Conclusion: Considering the importance of the Stewardship component, cost control and improving the efficiency of the health system in the current conditions of the country can be considered through the implementation of infrastructure reforms in the Stewardship. Also, achieving service-based benefits, general population coverage, financing, and operational processes can be achieved through medium-term and
long-term plans.
Narges Asadi Janati, Khalil Alimohammadzade, Seyd Mojtaba Hosseini, Ali Maher, Mohammadkarim Bahadori,
Volume 3, Issue 1 (4-2020)
Abstract
Introduction: Donors participation in the health sector is one of the sources of financing in the healthcare system. According to rising costs of the healthcare system in recent years and consequently increase in out of pockets of people, more attention has been paid to the charitable donations. In order to maintain and increase good support and participation in the health system, the need to identify and remove the barriers they face is essential for Efficient and effectiveness participation.
Methods: the present study according to purpose is applied, Descriptive research in terms of data collection and In terms of type of research data is qualitative. Required data were collected through semi-structured interviews with 41 health experts and beneficiaries using snowball sampling method.Conventional Content analysis was used to analyze the data.
Results: Surveying and categorizing the interviews showed that Efficient and effectiveness participation of Donors in the healthcare system involves four main barriers: Lack of legal mechanisms, Lack of proper and continuous communication with the beneficiary, barriers in the field of management and effective allocation of resources, Lack of awareness of Donors from needs and barriers of the healthcare system and 18 subtheme.
Conclusion: By recognizing and solving these barriers, it has channeled the funds and contributions of the Donors towards the needs of the healthcare system with maximum effectiveness. Can be enhanced by strengthening institutions, structures and processes, Developing facilitator laws, Correct and constant communication with beneficiary and identifying priorities and needs and transferring them to the beneficiaries of health, can be facilitated and encouraged maximum donation.
Keywords: Healthcare Financing, Donors, Barriers,Conventional Content Analysis.
