Showing 8 results for Rezaee
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.
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.
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.
Maryam Ghamkhar, Mehdi Rezaee, Mohammad Effatpanah, Alireza Namazi Shabestari, Leila Ghamkhar,
Volume 6, Issue 1 (Spring 2023)
Abstract
This article has no abstract.
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.
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.
Mohammadreza Rezaee, Keivan Babadi, Hasan Saeidi,
Volume 7, Issue 2 (Summer 2024)
Abstract
Introduction: The Villagers and Nomads' Family Physician Program in Khuzestan Province was implemented to provide primary medical and health services to the rural and nomadic populations, aiming to improve their quality of life by focusing on disease prevention and management.
Methods: In this study, questionnaires were used to collect data to determine the challenges of implementing the family physician plan from the perspectives of plan monitors and participating physicians, focusing on nine areas. Questionnaires were sent to all 235 members of the health team, and plan monitors in Khuzestan Province, and 177 members completed the survey. The findings of this quantitative study were analyzed using descriptive statistics, chi-squared tests, and Mann-Whitney tests at a significance level of 0.05.
Results: The results indicated that physicians' low job attractiveness, with an average score of 7.43, impairs their persistence, which is identified as the most important challenge.
Conclusion: Considering the difficulty of the job and the adequacy of facilities and amenities, attention should be paid to the motivational and financial needs of health team members when setting executive guidelines.
Dr Ali Tavoosian, Dr Sana Ahmadi, Dr Mahdi Rezaee,
Volume 27, Issue 7 (12-2024)
Abstract
Introduction: Failure to remove a double-G stent on time and its retention will result in many complications for the patient. In this study, we intend to examine two approaches to follow-up and follow-up of patients after urological surgeries, considering the importance of timely follow-up and removal of double-G stents and the importance of patient follow-up.
Methods: This retrospective study was conducted at Ziaian Medical Center. A total of 573 patients underwent double-G stent implantation over a period of 10 years and in two 5-year periods, of which 8 patients were eligible for the title of forgotten double-G stent.
Results: During the 5-year period, the number of double-G stent implantation cases at Ziaian Medical Center was 224, of which 7 cases were hospitalized due to failure to continue follow-up treatment and as a result, failure to remove the stent. Between 2019 and 2023, the number of double-G stent implantations was 349, of which 3 patients were called for follow-up treatment and removal of the double-G stent using a telephone follow-up system.
Conclusion: This study attempts to present the role of designing low-cost follow-up systems for continuing treatment and postoperative examinations in a transparent manner so that physicians and other medical staff realize the importance of providing and designing a coordinated, simplified, operational, and inexpensive system for coherent patient follow-up.
