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Attributes Related to Dissatisfaction with Health Insurance Coverage in Patients Visiting to Dental Clinics in Tehran City
Jamileh Vahidi, Amirhossein Takian, Mostafa Amini Rarani, Moeeni Maryam,
Volume 3, Issue 3 (10-2020)
Abstract
Introduction:  The patients ‘satisfaction with health service is one of the five indicators of quality evaluation in health care programs. This study aimed to identify the attributes related to the non-satisfaction of insurance coverage among patients visited to dental clinics.
Methods: In the framework of a qualitative study conducted in Tehran city, six private and public dental clinics were selected in regions with variant socio-economic status. Face-to-face interviews with the head of household or their spouses who visited to selected dental clinics were carried out and sampling continued until saturation. Data collection lasted from October until February 2018. Thematic analysis was used for content analysis and MAXQDA12 software was applied for data analys
Results: 54 interviews were conducted and overall 14 codes were extracted. Peculiarity and non-peculiarity attributes were identified as two main attributes related to dissatisfaction of the basic and complementary health insurance. To more detail, both basic and complementary insured interviewees expressed dissatisfaction with high premiums, inadequate service packages, as well as rarity of contract centers. Moreover, the interviewees with basic insurance were highly dissatisfied with quality of health services, and those of complementary coverage were dissatisfied with reimbursement system of insurance.
Conclusion: The findings suggest that in order to improve the level of satisfaction with insurance coverage, it is necessary for policy makers to consider the affordability of insurance coverage, insurance packages, and also the quality of health services provided by insurers.
A review of Iranian health system's laws, policies and reforms over the last four decades: A retrospective approach
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.

Inequality in Health Financing Policies: A Fundamental Challenge of Social Equity in Iran
Amirhossein Takian, Alireza Olyaeemanesh, Efat Mohamadi,
Volume 5, Issue 1 (3-2022)
Abstract

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.

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