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آیا ارزان‌سازی خدمات سلامت آرزوی غیرقابل دستیابی است؟ Is the Cheapening of Health Services an Unattainable Wish? 1 1 3 2024/04/21 1403/2/2 2024/05/14 1403/2/25 علی‌اکبر حق‌دوست Aliakbar Haghdoost مرکز تحقیقات مراقبت HIV و عفونت‌های آمیزشی، پژوهشکده آینده‌پژوهی در سلامت، دانشگاه علوم پزشکی کرمان، کرمان، ایران ahaghdoost@gmail.com ## ##

تابلوی تقاضای القایی ارائه‌کنندگان خدمات تشخیصی درمانی در جهان؛ یک مرور حیطه‌ای Induced Demand of Providers of Diagnostic and Therapeutic Services in the World; Scoping Review 1 1 مقدمه: تقاضای القایی یک چالش بزرگ برای تأمین مالی ارتقای سلامت است. صاحب‌نظران نقش مهم بیمه‌های سلامت را به‌عنوان محرک تقاضای ناشی از پزشک حتی در اقتصادهای جهانی نوظهور و پیشرفته برجسته دانسته‌اند. لذا اهمیت انجام مطالعات مروری درکشور برای دستیابی به روش‌های شناسایی تقاضای القایی بر کسی پوشیده نیست. روش بررسی: در این مطالعه از پایگاه‌های اطلاعاتی انگلیسی پاب مد، اسکوپوس، پروکوئست، کاکرین و وب آو ساینس و امبیس، جستجوی مقالات انجام گرفت. یافته‌ها: یافته‌ها نشان داد که حدود ۹۰ درصد مطالعات با روش‌های تحلیل آماری و بررسی ارتباط متغیرها به اثبات تقاضای القایی در خدمات تشخیصی درمانی پرداختند و موضوع تقاضای القایی همچنان یک موضوع مهم در جهان است. نتیجه‌گیری: ساختار بیمه‌ها به دلیل نقش اساسی که در پرداخت به ارائه‌کنندگان خدمات سلامت دارند در شکل گیری تقاضای القایی کاملاً موثرند و روش‌های پژوهشی این مقالات دیدگاه‌های کارآمدی برای سیاست‌گذاران سلامت کشور در شناخت و کنترل تقاضای القایی مطرح می‌کند. 2 Introduction: Induced demand is a major challenge for financing health promotion. Experts have highlighted the important role of health insurance as a driver of demand for doctors even in emerging and advanced world economies. Therefore, the importance of conducting review studies in the country to obtain methods for identifying induced demand is not hidden from anyone. Methods: In this study, articles were searched from English PubMed, Scopus, ProQuest, Cochrane and Web of Science databases. Results: The findings showed that about 90% of the studies proved the induced demand in diagnostic and therapeutic services with statistical analysis methods and investigating the relationship of variables, and the issue of induced demand is still an important issue in the world. Conclusion: The structure of insurances is quite effective in the formation of induced demand due to the fundamental role they play in paying health service providers, and the research methods of these articles provide effective perspectives for the country's health policy makers in recognizing and controlling induced demand. 4 13 2024/04/212024/01/3 1402/10/13 2024/05/142024/04/25 1403/2/6 اعظم‌السادات ریوندی Azamsadat Rivandi گروه مدیریت خدمات بهداشتی و درمانی، دانشکده بهداشت، دانشگاه علوم پزشکی آزاد اسلامی تهران، تهران، ایران azamsadatrivandi@gmail.com خلیل علی‌محمدزاده Khalil Alimohammadzadeh گروه مدیریت خدمات بهداشتی و درمانی، دانشکده بهداشت، دانشگاه علوم پزشکی آزاد اسلامی تهران، تهران، ایران dr_khalil_amz@yahoo.com سارا امامقلی پورسفیددشتی Sara Emamgholipour Sefiddashti گروه مدیریت و اقتصاد سلامت، دانشکده بهداشت، دانشگاه علوم پزشکی تهران، تهران، ایران s-emamgholipour@tums.ac.ir علی ماهر Ali Maher گروه اقتصاد، مدیریت و سیاست گذاری سلامت، دانشکده بهداشت و ایمنی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران dralimaher@gmail.com امین قاسم‌بیگلو Amin Ghasem Begloo گروه مدیریت خدمات بهداشتی و درمانی، دانشکده بهداشت، دانشگاه علوم پزشکی آزاد اسلامی تهران، تهران، ایران Begloo.am@gmail.com Inductive Demand Financing Health Services تقاضای القایی تأمین مالی خدمات سلامت References##1. 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Int J Environ Res Public Health. 2019;16(17):3167. doi: 10.3390/ijerph16173167.##11. Deng KB, Ding Z, Li JN. Medical insurance and physician-induced demand in China: the case of hemorrhoid treatments. Int J Health Econ Manag. 2022;22(3):257-94. doi: 10.1007/s10754-021-09318-1.##12. Health Insurance Organization [Internet]. 2020 [cited 2020]. Available from: https://ihio.gov.ir. [Persian]##13. Ikegami K, Onishi K, Wakamori N. Competition-driven physician-induced demand. J Health Econ. 2021:79:102488. doi: 10.1016/j.jhealeco.2021.102488.##14. Rodgers BL, Jacelon CS, Knafl KA. Concept analysis and the advance of nursing knowledge: state of the science. J Nurs Scholarsh. 2018;50(4):451-9. doi: 10.1111/jnu.12386.##15. Folland S, Goodman AC, Stano M. The economics of health and health care: Pearson new international edition: Routledge; 2016. doi: 10.4324/9781315510736.##16. Tavares AI, Marques I. 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Bernardy M, Ullrich CG, Rawson JV, Allen Jr B, Thrall JH, Keysor KJ, et al. Strategies for managing imaging utilization. J Am Coll Radiol. 2009;6(12):844-50. doi: 10.1016/j.jacr.2009.08.003.##22. Besanko D, Dranove D, Garthwaite C. Insurance Access and Demand Response: Pricing and Welfare Implications. J Health Econ. 2020;73:102329. doi: 10.1016/j.jhealeco.2020.102329.##23. Akhavan Rezayat S, Emam Gholi Pour S, AliKhassi A, Habibi Z, Ahmadi B. A survey on the amount of unnecessary brain and spine magnetic resonance imaging and reasons to affect it in Tehran, Iran. Int J Finance Econ. 2023;28(1):996-1005. doi: 10.1002/ijfe.2460.##24. Mohammadshahi M, Yazdani S, Olyaeemanesh A, Sari AA, Yaseri M, Sefiddashti SE. A scoping review of components of physician-induced demand for designing a conceptual framework. J Prev Med Public Health. 2019;52(2):72. doi: 10.3961/jpmph.18.238.##25. Shigeoka H, Fushimi K. Supplier-induced demand for newborn treatment: evidence from Japan. 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J Jpn Int Econ. 2016;40:1-16. doi: 10.1016/j.jjie.2016.03.001.##30. Si Y, Zhou Z, Su M, Hu H, Yang Z, Chen X. Re-Examining Supplier-Induced Demand in Health Care: Comparisons among Patients Affiliated and Not Affiliated with Healthcare Professionals in China. IZA Discussion Papers. 2020;13800:1-19. doi: 10.2139/ssrn.3718180.##31. Yu J, Qiu Y, He Z. Is universal and uniform health insurance better for China? Evidence from the perspective of supply-induced demand. Health Econ Policy Law. 2020;15(1):56-71. doi: 10.1017/S1744133118000385.##32. Tavares AI, Marques I. Multi-layer health insurance coverage, medical services use and health in a Universal National Health System, the case of Portugal. Eur J Health Econ. 2020:141-53. doi: 10.1007/s10198-020-01242-4.##33. Ikegami K, Onishi K, Wakamori N. Induced Physician-Induced Demand. Japan: Faculty of Economics, University of Tokyo, 2020. doi: 10.1016/j.jhealeco.2021.102488.##34. Crettez B, Deloche R, Jeanneret‐Crettez MH. A demand‐induced overtreatment model with heterogeneous experts. J Public Econ Theory. 2020;22(5):1713-33. doi: 10.1111/jpet.12465.##35. Akbari M, Arani AA, Akbari ME, Sahabi B, Olyaeemanesh A. Supplier-Induced Demand in Diagnostic MRI of Primary Breast Cancer. Iran J Health Sci. 2020;8(4):20-7. [Persian] doi: 10.18502/jhs.v8i4.4791.##36. Akhavan Behbahani A, Esmaili I. Supplier-induced demand (SID) for medical services by Iranian physicians (policymaking and controlling). parliament and Strategic Quarterly. 2019;25(96):321-41. [Persian]##37. Longden T, Hall J, van Gool K. Supplier‐induced demand for urgent after‐hours primary care services. Health Econ. 2018;27(10):1594-608. doi: 10.1002/hec.3779.##38. Glied S, Hong K. Health care in a multi-payer system: Spillovers of health care service demand among adults under 65 on utilization and outcomes in medicare. J Health Econ. 2018;60:165-76. doi: 10.1016/j.jhealeco.2018.05.001.##39. Cho S-J, Kim D, Yun E-J. The Impact of Diagnostic Imaging Fee Changes to Medical Provider Behavior: Focused on the Number of Exams of Computed Tomograph. Health Policy Manag. 2018;28(2):138-44.##40. Nguyen LL, Smith AD, Scully RE, Jiang W, Learn PA, Lipsitz SR, et al. Provider-induced demand in the treatment of carotid artery stenosis: variation in treatment decisions between private sector fee-for-service vs salary-based military physicians. JAMA Surg. 2017;152(6):565-72. doi: 10.1001/jamasurg.2017.0077.##41. Rao VM, Levin DC. The overuse of diagnostic imaging and the Choosing Wisely initiative. Ann Intern Med. 2012;157(8):574-6. doi: 10.7326/0003-4819-157-8-201210160-00535.##42. Ohyama Y, Nakai M, Sumita Y, Iwanaga Y, Nakamura T, Kurabayashi M, et al. Physician-induced demand for acute cardiovascular inpatient care in Japan: an analysis of 3,546,181 admissions from jroad database. J Am Coll Cardiol. 2022;79(9_Supplement):1520. doi: 10.1016/S0735-1097(22)02511-6.##43. 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Physician-induced demand hypothesis in iran: Impact of the physician density on treatment costs. Iran J Insur Res. 2017;6(4):221-31. [Persian]##2. Gao YF, Yu XM, Xu CW, Deng GP, editors. Do Competition among Physicians Control Physician Induced Demand: A Case Study in China. Budapest: 8th International Conference on Biotechnology and Bioengineering (ICBB); 2018. pp.24-26. doi: 10.1063/1.5092417.##3. Seyedin H, Afshari M, Isfahani P, Hasanzadeh E, Radinmanesh M, Bahador RC. The main factors of supplier-induced demand in health care: A qualitative study. J Educ Health Promot. 2021:10:49. doi: 10.4103/jehp.jehp_68_20.##4. Yoshida A, Kawamura A. Competition and Physician Induced Demand: Evidence from Dental Service Market in Japan.##5. Sekhri N, Savedoff W. Regulating private health insurance to serve the public interest: policy issues for developing countries. Int J Health Plann Manage. 2006;21(4):357-92. doi: 10.1002/hpm.857.##6. McGuire T. Physician agency. Handbook of Health Economics. Edited by: Culyer A, Newhouse J. 2000. Elsevier; 2000. doi: 10.1016/S1574-0064(00)80168-7.##7. Khorasani E, Keyvanara M, Karimi S, Jazi MJ. Views of health system experts on macro factors of induced demand. Int J Prev Med. 2014;5(10):1286.##8. Zabrodina V, Dusheiko M, Moschetti K. A moneymaking scan: Dual reimbursement systems and supplier‐induced demand for diagnostic imaging. Health Econ. 2020;29(12):1566-85. doi: 10.1002/hec.4152.##9. Alinia C, Takian A, Saravi N, Yusefzadeh H, Piroozi B, Olyaeemanesh A. Physician induced demand for knee replacement surgery in Iran. BMC Health Serv Res. 2021;21(1):763. doi: 10.1186/s12913-021-06697-6.##10. Yan YH, Kung CM, Yeh HM. The Impacts of the Hierarchical Medical System on National Health Insurance on the Resident's Health Seeking Behavior in Taiwan: A Case Study on the Policy to Reduce Hospital Visits. Int J Environ Res Public Health. 2019;16(17):3167. doi: 10.3390/ijerph16173167.##11. Deng KB, Ding Z, Li JN. Medical insurance and physician-induced demand in China: the case of hemorrhoid treatments. Int J Health Econ Manag. 2022;22(3):257-94. doi: 10.1007/s10754-021-09318-1.##12. Health Insurance Organization [Internet]. 2020 [cited 2020]. Available from: https://ihio.gov.ir. [Persian]##13. Ikegami K, Onishi K, Wakamori N. Competition-driven physician-induced demand. J Health Econ. 2021:79:102488. doi: 10.1016/j.jhealeco.2021.102488.##14. Rodgers BL, Jacelon CS, Knafl KA. Concept analysis and the advance of nursing knowledge: state of the science. J Nurs Scholarsh. 2018;50(4):451-9. doi: 10.1111/jnu.12386.##15. Folland S, Goodman AC, Stano M. The economics of health and health care: Pearson new international edition: Routledge; 2016. doi: 10.4324/9781315510736.##16. Tavares AI, Marques I. Multi-layer health insurance coverage, medical services use and health in a Universal National Health System, the case of Portugal. Eur J Health Econ . 2021;22(1):141-53. doi: 10.1007/s10198-020-01242-4.##17. Labelle R, Stoddart G, Rice T. A re-examination of the meaning and importance of supplier-induced demand. J Health Econ. 1994;13(3):347-68. doi: 10.1016/0167-6296(94)90036-1.##18. Stano M. An analysis of the evidence on competition in the physician services markets. J Health Econ. 1985;4(3):197-211. doi: 10.1016/0167-6296(85)90029-3.##19. Beingana G, Ngomi N, Habtu M. The influence of health technology on principal-agent relationship: a study of virtual doctor consultations in Rwanda. Health Technol (Berl). 2021;11(1):39-47. doi: 10.1007/s12553-020-00491-w.##20. Si Y, Su M, Dong W, Yang Z, Zhou Z, Chen X. Importance of medical information for health-care utilisation in China: A cross-sectional study. Lancet. 2018;392:S49. doi: 10.1016/S0140-6736(18)32678-3.##21. Bernardy M, Ullrich CG, Rawson JV, Allen Jr B, Thrall JH, Keysor KJ, et al. Strategies for managing imaging utilization. J Am Coll Radiol. 2009;6(12):844-50. doi: 10.1016/j.jacr.2009.08.003.##22. Besanko D, Dranove D, Garthwaite C. Insurance Access and Demand Response: Pricing and Welfare Implications. J Health Econ. 2020;73:102329. doi: 10.1016/j.jhealeco.2020.102329.##23. Akhavan Rezayat S, Emam Gholi Pour S, AliKhassi A, Habibi Z, Ahmadi B. A survey on the amount of unnecessary brain and spine magnetic resonance imaging and reasons to affect it in Tehran, Iran. Int J Finance Econ. 2023;28(1):996-1005. doi: 10.1002/ijfe.2460.##24. Mohammadshahi M, Yazdani S, Olyaeemanesh A, Sari AA, Yaseri M, Sefiddashti SE. A scoping review of components of physician-induced demand for designing a conceptual framework. J Prev Med Public Health. 2019;52(2):72. doi: 10.3961/jpmph.18.238.##25. Shigeoka H, Fushimi K. Supplier-induced demand for newborn treatment: evidence from Japan. J Health Econ. 2014;35:162-78. doi: 10.1016/j.jhealeco.2014.03.003.##26. Sekimoto M, Ii M. Supplier-induced demand for chronic disease care in Japan: multilevel analysis of the association between physician density and physician-patient encounter frequency. Value Health Reg Issues. 2015;6:103-10. doi: 10.1016/j.vhri.2015.03.010.##27. Yu J, Qiu Y, He Z. Is universal and uniform health insurance better for China? Evidence from the perspective of supply-induced demand. Health Econ Policy Law. 2020;15(1):56-71. doi: 10.1017/S1744133118000385.##28. Maeda T, Babazono A, Nishi T, Yasui M, Harano Y. Investigation of the existence of supplier-induced demand in use of gastrostomy among older adults: a retrospective cohort study. Medicine (Baltimore). 2016;95(5):e2519. doi: 10.1097/MD.0000000000002519.##29. Sugawara S, Nakamura J. Gatekeeper incentives and demand inducement: An empirical analysis of care managers in the Japanese long-term care insurance program. J Jpn Int Econ. 2016;40:1-16. doi: 10.1016/j.jjie.2016.03.001.##30. Si Y, Zhou Z, Su M, Hu H, Yang Z, Chen X. Re-Examining Supplier-Induced Demand in Health Care: Comparisons among Patients Affiliated and Not Affiliated with Healthcare Professionals in China. IZA Discussion Papers. 2020;13800:1-19. doi: 10.2139/ssrn.3718180.##31. Yu J, Qiu Y, He Z. Is universal and uniform health insurance better for China? Evidence from the perspective of supply-induced demand. Health Econ Policy Law. 2020;15(1):56-71. doi: 10.1017/S1744133118000385.##32. Tavares AI, Marques I. Multi-layer health insurance coverage, medical services use and health in a Universal National Health System, the case of Portugal. Eur J Health Econ. 2020:141-53. doi: 10.1007/s10198-020-01242-4.##33. Ikegami K, Onishi K, Wakamori N. Induced Physician-Induced Demand. Japan: Faculty of Economics, University of Tokyo, 2020. doi: 10.1016/j.jhealeco.2021.102488.##34. Crettez B, Deloche R, Jeanneret‐Crettez MH. A demand‐induced overtreatment model with heterogeneous experts. J Public Econ Theory. 2020;22(5):1713-33. doi: 10.1111/jpet.12465.##35. Akbari M, Arani AA, Akbari ME, Sahabi B, Olyaeemanesh A. Supplier-Induced Demand in Diagnostic MRI of Primary Breast Cancer. Iran J Health Sci. 2020;8(4):20-7. [Persian] doi: 10.18502/jhs.v8i4.4791.##36. Akhavan Behbahani A, Esmaili I. Supplier-induced demand (SID) for medical services by Iranian physicians (policymaking and controlling). parliament and Strategic Quarterly. 2019;25(96):321-41. [Persian]##37. Longden T, Hall J, van Gool K. Supplier‐induced demand for urgent after‐hours primary care services. Health Econ. 2018;27(10):1594-608. doi: 10.1002/hec.3779.##38. Glied S, Hong K. Health care in a multi-payer system: Spillovers of health care service demand among adults under 65 on utilization and outcomes in medicare. J Health Econ. 2018;60:165-76. doi: 10.1016/j.jhealeco.2018.05.001.##39. Cho S-J, Kim D, Yun E-J. The Impact of Diagnostic Imaging Fee Changes to Medical Provider Behavior: Focused on the Number of Exams of Computed Tomograph. Health Policy Manag. 2018;28(2):138-44.##40. Nguyen LL, Smith AD, Scully RE, Jiang W, Learn PA, Lipsitz SR, et al. Provider-induced demand in the treatment of carotid artery stenosis: variation in treatment decisions between private sector fee-for-service vs salary-based military physicians. JAMA Surg. 2017;152(6):565-72. doi: 10.1001/jamasurg.2017.0077.##41. Rao VM, Levin DC. The overuse of diagnostic imaging and the Choosing Wisely initiative. Ann Intern Med. 2012;157(8):574-6. doi: 10.7326/0003-4819-157-8-201210160-00535.##42. Ohyama Y, Nakai M, Sumita Y, Iwanaga Y, Nakamura T, Kurabayashi M, et al. Physician-induced demand for acute cardiovascular inpatient care in Japan: an analysis of 3,546,181 admissions from jroad database. J Am Coll Cardiol. 2022;79(9_Supplement):1520. doi: 10.1016/S0735-1097(22)02511-6.##43. 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ارزیابی میزان رضایتمندی و کاربردپذیری هوش کسب و کار در سازمان بیمه سلامت ایران Evaluating the Satisfaction and Applicability of Business Intelligence (BI) in Iran Health Insurance Organization 1 1 مقدمه: امروزه اکثر سازمان‌ها با حجم عظیمی از داده‏‌ها روبرو هستند. سازمان بیمه سلامت ایران با گردش مالی بسیار بالا از سال ۱۳۹۷ برای مدیریت بهتر هزینه‌‏های درمانی از فناوری هوش کسب و کار، از ۶۰ داشبورد اطلاعاتی استفاده نموده است. این مطالعه با هدف بررسی میزان رضایتمندی و کاربردپذیری هوش کسب و کار (BI) در سازمان بیمه سلامت ایران انجام شد. روش بررسی: مطالعه توصیفی-تحلیلی و کاربردی که به‌صورت مقطعی در سال ۱۴۰۲ انجام شد. جامعه مطالعه ۴۰۱ نفر، ابزار جمع آوری داده‏‌ها پرسشنامه محقق ساخته است. پایایی و روایی پرسشنامه کنترل و مورد تأیید قرار گرفت. ۳۱۱ نفر پرسشنامه را تکمیل کردند. برای توصیف داده‌ها از روش‌های آمار توصیفی شامل میانگین، انحراف معیار و ضرایب چولگی و کشیدگی و در بخش آمار استنباطی برای تحلیل داده‏ها از آزمون‌‌های t گروه‌های مستقل و آنالیز واریانس استفاده شد. یافته‏‌ها: از نظر جنس ۶۵.۹ درصد پاسخگویان مرد، افراد با سابقه بیشتر از ۲۵ سال، بیشترین (۷-۲۷ درصد) و افراد با سابقه کمتر از ۵ سال، کمترین (۲.۶ درصد) گروه را تشکیل می‌‏دادند. مستخدمین رسمی با ۷۳.۶ درصد بیشترین گروه پاسخگویان از نظر نوع استخدام را به‌خود اختصاص دادند. بیشترین رضایت­مندی در متغیر "بهبود در تصمیم‌گیری بوسیله داشبوردها" با میانگین ۳.۷۱ (میزان رضایتمندی ۷۴.۱ درصد) و کمترین رضایت‏مندی مربوط به متغیر "محتوای داده‌‏های داشبوردها" با میانگین ۳.۵۸ (میزان رضایتمندی ۶۳.۲ درصد) می‏باشد. میانگین رضایتمندی در مجموع معادل، ۳.۶۴ (میزان رضایتمندی ۷۲.۸ درصد) می‌­باشد. نتیجه‌گیری: فناوری‌های نوین، بویژه فناوری­‌های هوش کسب و کار، می‌­تواند کمک موثری به سازمان‌ها داشته باشد. 2 Introduction: Nowadays, most organizations deal with a tremendous volume of data. The Iran Health Insurance Organization, with a significant financial turnover, has utilized 60 information dashboards since 2017 to enhance the management of medical costs through business intelligence technologies. The purpose of this paper was to investigate the level of satisfaction and applicability of business intelligence (BI) in Iran's health insurance organization. Methods: A descriptive-analytical and applied cross-sectional study conducted in 2023 involved a population of 401 participants. The study population consists of 401 people, which consists of the questionnaire data collection tool developed by the researcher. The reliability and validity of the questionnaire was checked and confirmed. 311 people completed the questionnaire. Descriptive statistics including mean, standard deviation, skewness and kurtosis coefficients were used to describe the data, and T-tests and analysis of variance were used in the statistical inference to analyze data. Results: 65.9% of male respondents, people with experience more than 25 years, the most (27.7%) and people with experience less than 5 years, the least (2.6%) group. Official employees accounted for the largest group of respondents with 73.6%. The highest satisfaction is found in the variable "improvement in decision-making through dashboards" with an average of 3.71 (74.1% satisfaction rate), while the lowest satisfaction is related to the variable "data content of the dashboards" with an average of 3.58 (63.2% satisfaction rate). The average satisfaction in total is 3.64 (satisfaction rate 72.8%). Conclusion: New technologies, especially business intelligence technologies, can help organizations effectively. 14 21 2024/04/212024/01/32024/02/26 1402/12/7 2024/05/142024/04/252024/05/18 1403/2/29 امیرحسین حبیبیان Amir Hossein Habibian گروه مدیریت، دانشگاه پیام نور تهران، تهران، ایران habibian@ihio.gov.ir امیرهوشنگ تاج‌فر Amir Houshang Tajfar گروه مدیریت، دانشگاه پیام نور تهران، تهران، ایران amir.tajfar@pnu.ac.ir محمدرضا جمالی Mohammadreza Jamali مرکز ملی تحقیقات بیمه سلامت، تهران، ایران jamali.m@ihio.gov.ir Dashboard Business Intelligence Satisfaction Applicability داشبورد هوش کسب و کار رضایت‌مندی کاربردپذیری ## ##

شاخص‌های ارزیابی عملکرد سازمان بیمه سلامت ایران بر اساس اسناد بالادستی Performance Evaluation Indicators of Iran Health Insurance Organization Based on Macro Policies 1 1 مقدمه: بررسی عملکرد سازمان بیمه سلامت ایران با توجه به اهدافی که برای این سازمان در اسناد و قوانین بالادستی در نظر گرفته شده است، موضوع مهمی است که کمتر به آن پرداخته شده است. مطالعه حاضر به شناسایی شاخص‌های عملکردی سازمان بیمه سلامت ایران براساس تحلیل اسناد و قوانین مرتبط در راستای رصد برنامه­‌ها و سیاست­های کلان این سازمان پرداخته است. روش بررسی: این مطالعه به صورت کیفی و مبتنی بر تحلیل محتوای اسناد، برنامه ها و فعالیت های اجرایی سیاست های مرتبط با نظارت بر عملکرد سازمان بیمه سلامت ایران، از سال تصویب قانون بیمه همگانی خدمات درمانی کشور (۱۳۷۳) تا سال ۱۴۰۲، در سال ۱۴۰۲ انجام شد. از روش اسکات برای بررسی اعتبار اسناد و از تحلیل محتوای کیفی و رویکرد جزء به کل برای تحلیل داده­‌ها بهره گرفته شد. یافته‌ها: شاخص های شناسایی شده برگرفته از نه سیاست در ۱۱ موضوع و ۱۸۸ شاخص دسته بندی شدند: شاخص جمعیتی (۴.۶۵ درصد)، حساب‌های ملی سلامت (۷.۵۵ درصد)، جمعیت تحت پوشش (۱۴.۵۳ درصد)، خدمات سلامت تحت پوشش (۹.۸۸ درصد)، هزینه‌های تحت پوشش/ وضعیت مشارکت مالی (۶.۳۹ درصد)، منابع مالی سازمان (۱۱.۶۲ درصد)، مراکز طرف قرارداد (۵.۸۱ درصد)، روند هزینه‌ها. بار هزینه. بار مراجعه (۱۳.۳۷ درصد)، شاخص‌های نظارتی (۶.۳۹ درصد)، کارایی عملیاتی سازمان (۱۳.۳۷ درصد)، دسترسی به خدمات و پیامد سلامت (۶.۳۹ درصد). نتیجه‌گیری: برای ارزیابی صحیح و جامع عملکرد سازمان بیمه سلامت ایران به گونه‌ای که افزایش شفافیت و اعتماد عمومی را برای این سازمان به همراه داشته باشد در نظر گرفتن شاخص‌های متعدد از جمله شاخص‌های جمعیتی و حساب‌های ملی سلامت، به گونه‌ای که کلیه ابعاد اجرایی و عملکردی یک سازمان بیه سلامت را پوشش دهد مورد نیاز می باشد. 2 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. 22 41 2024/04/212024/01/32024/02/262024/01/7 1402/10/17 2024/05/142024/04/252024/05/182024/03/16 1402/12/26 عفت محمدی Efat Mohamadi مرکز تحقیقات عدالت در سلامت، دانشگاه علوم پزشکی تهران، تهران، ایران e-mohamadi@sina.tums.ac.ir احد بختیاری Ahad Bakhtiari مرکز تحقیقات عدالت در سلامت، دانشگاه علوم پزشکی تهران، تهران، ایران ahbakhtyari@gmail.com محمدمهدی ناصحی Mohammad Mehdi Nasehi مرکز ملی تحقیقات بیمه سلامت، تهران، ایران mmnasehi@gmail.com محمد عفت‌پناه Mohammad Effatpanah مرکز ملی تحقیقات بیمه سلامت، تهران، ایران m.effatpanah@gmail.com مهدی رضایی Mehdi Rezaei مرکز ملی تحقیقات بیمه سلامت، تهران، ایران rezaee.mehdi96@gmail.com زهرا شاهعلی Zahra Shahali مرکز ملی تحقیقات بیمه سلامت، تهران، ایران z.shahali3000@ihio.gov.ir امیرحسین تکیان Amirhossein Takian مرکز تحقیقات عدالت در سلامت، دانشگاه علوم پزشکی تهران، تهران، ایران takian@tums.ac.ir علیرضا اولیایی‌منش Alireza Olyaeemanesh مرکز تحقیقات عدالت در سلامت، دانشگاه علوم پزشکی تهران، تهران، ایران arolyaee@gmail.com Performance Evaluation Macro Policies Health Insurance Organization Indicator Health Policy ارزیابی عملکرد سیاست‌های بالادستی سازمان بیمه سلامت شاخص سیاست‌گذاری سلامت 1. Aguinis H. Performance management: Pearson; 2013.##2. Palm T. Performance assessment and authentic assessment: A conceptual analysis of the literature. Practical Assessment, Research, and Evaluation. 2008;13(1):4.##3. Amaratunga D, Baldry D. Moving from performance measurement to performance management. Facilities. 2002;20(5/6):217-23.##4. ER T, OR L, ION T. Multilateral Organisation Performance Assessment Network.##5. Rincón-Moreno J, Ormazábal M, Álvarez M, Jaca C. Advancing circular economy performance indicators and their application in Spanish companies. Journal of Cleaner Production. 2021;279:123605.##6. Levesque J-F, Sutherland K. Combining patient, clinical and system perspectives in assessing performance in healthcare: an integrated measurement framework. BMC health services research. 2020;20(1):1-14.##7. Garavan T, McCarthy A, Lai Y, Murphy K, Sheehan M, Carbery R. Training and organisational performance: A meta‐analysis of temporal, institutional and organisational context moderators. Human Resource Management Journal. 2021;31(1):93-119.##8. Abolhallaje M, Ramezanian M, Abolhasani N, Salarian Zade H, Hamidi H, Bastani P. Iranian health financing system: challenges and opportunities. World Appl Sci J. 2013;22(5):662-6.##9. Mohammadi E, Raissi AR, Barooni M, Ferdoosi M, Nuhi M. Survey of social health insurance structure in selected countries; providing framework for basic health insurance in Iran. Journal of education and health promotion. 2014;3.##10. Gorji A. Sanctions against Iran: the impact on health services. 2014.##11. راد م, رخشان ط, شیوا, افشاری, اصفهانی, پروانه. شاخص های ارزشیابی نظام تامین مالی سلامت: مرور حیطه ای. فصلنامه پژوهش حکیم. 2020;23(3):353-66.##12. محمدی, منش ا, تکیان, زاده ح, زاده م, نژادی ی, et al. تعیین شاخص های پایه مورد نیاز برای پایش و ارزشیابی برنامه ششم توسعه بخش سلامت. فصلنامه پژوهش حکیم. 2018;21(3):242-54.##13. Anderson M, Dobkin C, Gross T. The effect of health insurance coverage on the use of medical services. American Economic Journal: Economic Policy. 2012;4(1):1-27.##14. Börsch-Supan A, Schröder M. Retrospective data collection in the Survey of Health, Ageing and Retirement in Europe. SHARELIFE Methodol. 2011;5.##15. Su D, Chen Y-c, Gao H-x, Li H-m, Chang J-j, Jiang D, et al. Effect of integrated urban and rural residents medical insurance on the utilisation of medical services by residents in China: a propensity score matching with difference-in-differences regression approach. BMJ open. 2019;9(2):e026408.##16. Centers for Medicare & Medicaid Services. NHE Fact Sheet 2021 [Available from: https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet.##17. Simpson M, Green A, Banthin J. How Policies to Expand Insurance Coverage Affect Household Health Care Spending. 2023.##18. Erlangga D, Suhrcke M, Ali S, Bloor K. The impact of public health insurance on health care utilisation, financial protection and health status in low-and middle-income countries: a systematic review. PloS one. 2019;14(8):e0219731.##19. Darvishi A, Amini-Rarani M, Mehrolhassani MH, Yazdi-Feyzabadi V. Fairness in household financial contribution to the Iran’s healthcare system from 2008 to 2018. BMC research notes. 2021;14(1):1-5.##20. Ahadinezhad B, Khosravizadeh O, Alizadeh A, Nejatifar Z, Mehri M. Equity in Out-of-Pocket Payments for Healthcare Service Delivery in Urban and Rural Households: Evidence from Iran. International Journal of Health and Life Sciences. 2021;7(4).##21. Barney JB. Strategic factor markets: Expectations, luck, and business strategy. Management science. 1986;32(10):1231-41.##22. Jadi DM. An empirical analysis of determinants of financial performance of insurance companies in the United Kingdom: University of Bradford; 2015.##23. Mehari D, Aemiro T. FIRM SPECIFIC FACTORS THAT DETERMINE INSURANCE COMPANIES’PERFORMANCE IN ETHIOPIA. European scientific journal. 2013;9(10).##24. Nyongesa MN. Effect of financial management practices on financial performance of insurance companies in Kenya: COHRED-JKUAT; 2017.##25. Mathauer I, Dale E, Jowett M, Kutzin J. Purchasing health services for universal health coverage: How to make it more strategic? Purchasing health services for universal health coverage: How to make it more strategic?2019.##26. Faraji H, Kebriaeezadeh A. Is Strategic Purchasing in Iranian Insurance Companies Effective? Journal of Pharmacoeconomics and Pharmaceutical Management. 2021;7(1/2):1-2.##27. Douven R, Kauer L, Demme S, Paolucci F, van de Ven W, Wasem J, et al. Should administrative costs in health insurance be included in the risk-equalization? An analysis of five countries. The European Journal of Health Economics. 2022;23(9):1437-53.##28. Chernew M, Mintz H. Administrative expenses in the US health care system: Why so high? JAMA. 2021;326(17):1679-80.##29. Aziz N, Liu T, Yang S, Zukiewicz-Sobczak W. Causal relationship between health insurance and overall health status of children: Insights from Pakistan. Frontiers in Public Health. 2022;10:934007.##1. Aguinis H. Performance management: Pearson; 2013.##2. Palm T. Performance assessment and authentic assessment: A conceptual analysis of the literature. Practical Assessment, Research, and Evaluation. 2008;13(1):4.##3. Amaratunga D, Baldry D. Moving from performance measurement to performance management. Facilities. 2002;20(5/6):217-23.##4. ER T, OR L, ION T. Multilateral Organisation Performance Assessment Network.##5. Rincón-Moreno J, Ormazábal M, Álvarez M, Jaca C. Advancing circular economy performance indicators and their application in Spanish companies. Journal of Cleaner Production. 2021;279:123605.##6. Levesque J-F, Sutherland K. Combining patient, clinical and system perspectives in assessing performance in healthcare: an integrated measurement framework. BMC health services research. 2020;20(1):1-14.##7. Garavan T, McCarthy A, Lai Y, Murphy K, Sheehan M, Carbery R. Training and organisational performance: A meta‐analysis of temporal, institutional and organisational context moderators. Human Resource Management Journal. 2021;31(1):93-119.##8. Abolhallaje M, Ramezanian M, Abolhasani N, Salarian Zade H, Hamidi H, Bastani P. Iranian health financing system: challenges and opportunities. World Appl Sci J. 2013;22(5):662-6.##9. Mohammadi E, Raissi AR, Barooni M, Ferdoosi M, Nuhi M. Survey of social health insurance structure in selected countries; providing framework for basic health insurance in Iran. Journal of education and health promotion. 2014;3.##10. Gorji A. Sanctions against Iran: the impact on health services. 2014.##11. راد م, رخشان ط, شیوا, افشاری, اصفهانی, پروانه. شاخص های ارزشیابی نظام تامین مالی سلامت: مرور حیطه ای. فصلنامه پژوهش حکیم. 2020;23(3):353-66.##12. محمدی, منش ا, تکیان, زاده ح, زاده م, نژادی ی, et al. تعیین شاخص های پایه مورد نیاز برای پایش و ارزشیابی برنامه ششم توسعه بخش سلامت. فصلنامه پژوهش حکیم. 2018;21(3):242-54.##13. Anderson M, Dobkin C, Gross T. The effect of health insurance coverage on the use of medical services. American Economic Journal: Economic Policy. 2012;4(1):1-27.##14. Börsch-Supan A, Schröder M. Retrospective data collection in the Survey of Health, Ageing and Retirement in Europe. SHARELIFE Methodol. 2011;5.##15. Su D, Chen Y-c, Gao H-x, Li H-m, Chang J-j, Jiang D, et al. Effect of integrated urban and rural residents medical insurance on the utilisation of medical services by residents in China: a propensity score matching with difference-in-differences regression approach. BMJ open. 2019;9(2):e026408.##16. Centers for Medicare & Medicaid Services. NHE Fact Sheet 2021 [Available from: https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/nhe-fact-sheet.##17. Simpson M, Green A, Banthin J. How Policies to Expand Insurance Coverage Affect Household Health Care Spending. 2023.##18. Erlangga D, Suhrcke M, Ali S, Bloor K. The impact of public health insurance on health care utilisation, financial protection and health status in low-and middle-income countries: a systematic review. PloS one. 2019;14(8):e0219731.##19. Darvishi A, Amini-Rarani M, Mehrolhassani MH, Yazdi-Feyzabadi V. Fairness in household financial contribution to the Iran’s healthcare system from 2008 to 2018. BMC research notes. 2021;14(1):1-5.##20. Ahadinezhad B, Khosravizadeh O, Alizadeh A, Nejatifar Z, Mehri M. Equity in Out-of-Pocket Payments for Healthcare Service Delivery in Urban and Rural Households: Evidence from Iran. 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تمایل به پرداخت صاحبان مشاغل غیررسمی برای خرید بیمه سلامت در شهر اصفهان Willingness to Pay of Informal Job Workers for Health Insurance in Isfahan City, Iran 1 1 مقدمه: تکیه بر پرداخت از جیب خدمات مراقبت از سلامت، افزایش بار مالی و هزینه‌های کمرشکن خدمات درمانی برای خانواده‌ها نتیجه فقر را به همراه دارد. با توجه به ضرورت وجود بیمه درمانی پایدار برای مشاغل غیر رسمی، پژوهش حاضر به بررسی تمایل به پرداخت بیمه درمانی‌ همگانی سلامت برای مشاغل غیر‌ رسمی در شهر اصفهان برای دهک‌های درآمدی یک تا شش در دو گروه دهک­ درآمدی یک تا سه و دهک چهار تا شش پرداخت است. روش بررسی: در این مطالعه به برآورد میزان تمایل به پرداخت از روش ارزش‌‌گذاری مشروط (CVM) استفاده شد. در این پژوهش از روش کتابخانه‌­ای و میدانی پس از طراحی پرسشنامه برای جمع‌آوری داده‌­ها استفاده و از آنجا که متغیر وابسته (تمایل به پرداخت) به صورت رتبه‌­ای بود از روش های اقتصاد سنجی پروبیت رتبه‌ای و توبیت به برآورد الگو پرداخته شد. یافته‌ها: نتایج نشان داد تمایل به پرداخت صاحبان مشاغل غیررسمی برای خرید بیمه سلامت در شهر اصفهان در گروه اول (دهک ۱ تا ۳) برابر۴۸۷،۶۰۰ ریال و برای گروه دوم (دهک ۴ تا ۶) برابر ۵۱۳،۲۰۰ ریال است و در مجموع میانگین تمایل به پرداخت هر دو گروه یعنی دهک یک تا شش برابر ۵۰۰،۴۰۰ ریال است. همچنین اختلاف تمایل به پرداخت دو گروه ۵ درصد است. از پنج متغیر مستقل در هر دو گروه متغیر سطح تحصیلات تأثیر معنی داری بر تمایل به پرداخت ندارد اما سایر متغیرها از جمله سن، متوسط درآمد خانوار، و متوسط هزینه‌­های درمانی بر میزان تمایل به پرداخت تأثیرگذار هستند. همچنین اثر متغیر اندازه خانوار بر تمایل به پرداخت منفی شد. نتیجه گیری: نتایج نشان می هد که از دیدگاه اقتصاد رفتاری، شاغلان بخش غیر رسمی تمایل دارند با قیمتی کمتر از میانگین سهم حق بیمه شاغلان بخش رسمی، در بیمه‌های درمانی ثبت‌نام کنند. یارانه ها و تغییرات در ویژگی­‌های بیمه (به عنوان مثال از جمله تحت پوشش قراردادن بیماری­های خاص) در افزایش تمایل به پرداخت موثر باشد. 2 Introduction: Relying on out-of-pocket payments for health care services increases the financial burden and back-breaking costs of medical services for families. It results in poverty. Considering the necessity of sustainable medical insurance for informal jobs, the present study evaluated the willingness to pay medical insurance for informal jobs in Isfahan province for two groups of informal jobs in income deciles one to three and deciles four to six. Methods: In this study, the conditional valuation method (CVM) was used to estimate the willingness to pay. The maximum willingness to pay is equal to the compensatory interest, that is, the decrease in income that maintains the initial level of the respondent's utility if insurance coverage is provided. In this research, library and field methods were used to collect data, and since the dependent variable (willingness to pay) was ranked, the econometric methods of ordered probit and Tobit were used to estimate the model. Results: The results showed that in both groups of income deciles, the variable of education level has no significant effect on the willingness to pay, but other variables such as age, average household income, age and average medical expenses have an effect on the willingness to pay. The effect of changing household size was also negative. In the following, the practical suggestions obtained from the results were presented. 42 49 2024/04/212024/01/32024/02/262024/01/72024/02/2 1402/11/13 2024/05/142024/04/252024/05/182024/03/162024/05/12 1403/2/23 منصور عسکری Mansour Askary گروه اقتصاد، واحد خمینی‌شهر، دانشگاه آزاد اسلامی، خمینی‌شهر، اصفهان، ایران sky2@gmail.com مصطفی رجبی Mostafa Rajabi گروه اقتصاد، واحد خمینی‌شهر، دانشگاه آزاد اسلامی، خمینی‌شهر، اصفهان، ایران rajabi@iaukhsh.ac.ir شهرام توفیقی Sharam Tofighi گروه آینده‌نگری و نظریه‌پردازی و رصد کلان سلامت، فرهنگستان علوم پزشکی ایران، تهران، ایران shr_tofighi@yahoo.com مریم شریف‌دوست Maryam Sharifdoust گروه آمار، واحد خمینی‌شهر، دانشگاه آزاد اسلامی، خمینی‌شهر، اصفهان، ایران بهار حافظی Bahar Hafezi گروه اقتصاد، واحد خمینی‌شهر، دانشگاه آزاد اسلامی، خمینی‌شهر، اصفهان، ایران Contingent Valuation Willingness to Pay Health Insurance Household مشاغل غیر رسمی تمایل به پرداخت بیمه درمانی پروبیت رتبه ای و توبیت 1. Adel Nia, Amin, Rafiei, Hassan, Abbasian Ezzatolah, (2013), "Tendency to pay the costs of prescriptions of Isfahan social security insured persons", Ehsas Sociali, 14, 53, 77-89.##2. Ahmed, S., Hoque, M. E., Sarker, A. R., Sultana, M., Islam, Z., Gazi, R., & Khan,J. A. (2016). Willingness-to-pay for community-based health insurance among informal workers in urban Bangladesh. PloS one, 11(2), e0148211.##3. Amirenjad, Hamid, Azhdri, Samiyeh, (2009), "Comparison of the use of logit, probit and tobit in the economic valuation of environmental resources: a value study of circulation values in the lost paradise region of Fars province", Ekhzadat Keshavarzi, 5, 3, 119-95 .##4. Bärnighausen, T., Liu, Y., Zhang, X., & Sauerborn, R. (2007). Willingness to pay for social health insurance among informal sector workers in Wuhan, China: a contingent valuation study. BMC Health Services Research, 7(1), 114.##5. Djahini-Afawoubo, D. M., & Atake, E. H. (2018). Extension of mandatory health insurance to informal sector workers in Togo. Health economics review, 8(1), 22.##6. Gilbert, A. (1998). The latin american city. London: Latin America Bureau.##7. Iri, Hamid, (2016), "The degree of willingness of the residents of Gonbad Kavos city for dental insurance and related factors in the age group of 15 to 50 years", Master's Thesis, Islamic Azad University, Faculty of Management. .##8. Jafari Samimi, Ahmed, Karimi Patanlar, Saeed, Mohammadi, Taimur, Tatar, Musa, (2018), "The range of willingness to pay for supplementary medical insurance using the conditional valuation method (CV) and logit regression model", various issues . Iran Economy, Research Institute of Humanities and Cultural Studies, 6, 1, 107-81.##9. Jofre-Bonet, M., & Kamara, J. (2018). Willingness to pay for health insurance in the informal sector of Sierra Leone. PloS one, 13(5), e0189915.##10. Jumapour, Mahmoud, (2008), "Informal jobs as an urban and social and economic policy", Social Sciences Quarterly, 8 (15-16), 168-198.##11. Kamara, J., Jofre-Bonet, M., & Mesnard, A. (2018). A Discrete Choice Experiment to Elicit the Willingness to Pay for Health Insurance by the Informal Sector Workers in Sierra Leone. International Journal of Health Economics and Policy, 3(1).##12. Kazemian, Mahmoud, Alipour, Vahid, (2009), "Evaluation of the state of financial support and the role of the government in the policies of providing social insurance for treatment for the informal sector of work, Hakim, 13, 4, 275-267".##13. Kazemian, Mahmoud, Javadi Nesab, Hamideh, (2015), "Contingency evaluation and evaluation of the impact of social insurance expansion policies for the payment of low-income households in the informal sector", Sustainable Growth and Development Research, 16, 1, 1.##14. Krejcie, R.V., & Morgan, D.W., (1970). Determining Sample Size for Research Activities. Educational and Psychological Measurement.##15. Maher, Ali, Ferdowsi, Massoud, (2016), "Social Health Insurance, Terms and Definition of Concepts", Tehran, Tandis.##16. Marcinko, D. E., & Hetico, H. R. (Eds.). (2006). Dictionary of health insurance and managed care. Springer Publishing Company.##17. Moini, Maryam, Mehmed, Shokoofeh-Alsadat, Nusratnejad, Shirin, Karimi, Saeed, (2015), "Inclination of households to pay for insurance coverage of dental services: application of open-ended question method", Nizam Hakim Research, 19, 3, 169-163 . .##18. Moore, M. R. (1999). Estimating irrigators' ability to pay for reclamation water. Land economics, 562-578. ##19. Mould Quevedo, J. F., Contreras Hernández, I., Garduño Espinosa, J., & Salinas Escudero, G. (2009). The willingness-to-pay concept in question. Revista de saude publica, 43(2), 352-358.##20. Nazari, Mohsen, Asharipour, Mohammad Javad, (2015), "Investigation of price satisfaction and willingness to pay of supplementary treatment insurance policyholders (case study: an insurance company)", Insurance Research Journal (Insurance Industry), 31, 2, 122, 57-79.##21. Nosratnejad, S., Rashidian, A., Mehrara, M., Sari, A. A., Mahdavi, G., & Moeini, M. (2014). Willingness to pay for social health insurance in Iran. Global journal of health science, 6(5), 154.##22. Nosratnejad, S., Rashidian, A., Sari, A. A., & Moradi, N. (2017). Willingness to pay for complementary health care insurance in Iran. Iranian journal of public health, 46(9), 1247.##23. O'Brien, B., & Viramontes, J. L. (1994). Willingness to pay: a valid and reliable measure of health state preference?. Medical Decision Making, 14(3), 289-297.##24. Report of the National Health Research Institute of the Islamic Republic of Iran, (2018), "Universal health coverage in an active state, challenges, strategies".##25. Sales, R. K., Reyes, G. K., Ting, T., & Salvador Jr, D. (2020). Factors that affect social health insurance enrollment and retention of the informal sector in the Philippines: a qualitative study.##26. Thornton, R. L., Hatt, L. E., Field, E. M., Islam, M., Solís Diaz, F., & González, M. A. (2010). Social security health insurance for the informal sector in Nicaragua: a randomized evaluation. Health economics, 19(S1), 181-206.##27. Witati, W., & Putri, P. I. (2020). Determinant of Willingness to Pay Health Insurance Contribution to Informal Workers. Economics Development Analysis Journal, 9(2), 144-158.##1. Adel Nia, Amin, Rafiei, Hassan, Abbasian Ezzatolah, (2013), "Tendency to pay the costs of prescriptions of Isfahan social security insured persons", Ehsas Sociali, 14, 53, 77-89.##2. Ahmed, S., Hoque, M. E., Sarker, A. R., Sultana, M., Islam, Z., Gazi, R., & Khan,J. A. (2016). Willingness-to-pay for community-based health insurance among informal workers in urban Bangladesh. PloS one, 11(2), e0148211.##3. Amirenjad, Hamid, Azhdri, Samiyeh, (2009), "Comparison of the use of logit, probit and tobit in the economic valuation of environmental resources: a value study of circulation values in the lost paradise region of Fars province", Ekhzadat Keshavarzi, 5, 3, 119-95 .##4. Bärnighausen, T., Liu, Y., Zhang, X., & Sauerborn, R. (2007). Willingness to pay for social health insurance among informal sector workers in Wuhan, China: a contingent valuation study. BMC Health Services Research, 7(1), 114.##5. Djahini-Afawoubo, D. M., & Atake, E. H. (2018). Extension of mandatory health insurance to informal sector workers in Togo. Health economics review, 8(1), 22.##6. Gilbert, A. (1998). The latin american city. London: Latin America Bureau.##7. Iri, Hamid, (2016), "The degree of willingness of the residents of Gonbad Kavos city for dental insurance and related factors in the age group of 15 to 50 years", Master's Thesis, Islamic Azad University, Faculty of Management. .##8. Jafari Samimi, Ahmed, Karimi Patanlar, Saeed, Mohammadi, Taimur, Tatar, Musa, (2018), "The range of willingness to pay for supplementary medical insurance using the conditional valuation method (CV) and logit regression model", various issues . Iran Economy, Research Institute of Humanities and Cultural Studies, 6, 1, 107-81.##9. Jofre-Bonet, M., & Kamara, J. (2018). Willingness to pay for health insurance in the informal sector of Sierra Leone. PloS one, 13(5), e0189915.##10. Jumapour, Mahmoud, (2008), "Informal jobs as an urban and social and economic policy", Social Sciences Quarterly, 8 (15-16), 168-198.##11. Kamara, J., Jofre-Bonet, M., & Mesnard, A. (2018). A Discrete Choice Experiment to Elicit the Willingness to Pay for Health Insurance by the Informal Sector Workers in Sierra Leone. International Journal of Health Economics and Policy, 3(1).##12. Kazemian, Mahmoud, Alipour, Vahid, (2009), "Evaluation of the state of financial support and the role of the government in the policies of providing social insurance for treatment for the informal sector of work, Hakim, 13, 4, 275-267".##13. Kazemian, Mahmoud, Javadi Nesab, Hamideh, (2015), "Contingency evaluation and evaluation of the impact of social insurance expansion policies for the payment of low-income households in the informal sector", Sustainable Growth and Development Research, 16, 1, 1.##14. Krejcie, R.V., & Morgan, D.W., (1970). Determining Sample Size for Research Activities. Educational and Psychological Measurement.##15. Maher, Ali, Ferdowsi, Massoud, (2016), "Social Health Insurance, Terms and Definition of Concepts", Tehran, Tandis.##16. Marcinko, D. E., & Hetico, H. R. (Eds.). (2006). Dictionary of health insurance and managed care. Springer Publishing Company.##17. Moini, Maryam, Mehmed, Shokoofeh-Alsadat, Nusratnejad, Shirin, Karimi, Saeed, (2015), "Inclination of households to pay for insurance coverage of dental services: application of open-ended question method", Nizam Hakim Research, 19, 3, 169-163 . .##18. Moore, M. R. (1999). Estimating irrigators' ability to pay for reclamation water. Land economics, 562-578. ##19. Mould Quevedo, J. F., Contreras Hernández, I., Garduño Espinosa, J., & Salinas Escudero, G. (2009). The willingness-to-pay concept in question. Revista de saude publica, 43(2), 352-358.##20. Nazari, Mohsen, Asharipour, Mohammad Javad, (2015), "Investigation of price satisfaction and willingness to pay of supplementary treatment insurance policyholders (case study: an insurance company)", Insurance Research Journal (Insurance Industry), 31, 2, 122, 57-79.##21. Nosratnejad, S., Rashidian, A., Mehrara, M., Sari, A. A., Mahdavi, G., & Moeini, M. (2014). Willingness to pay for social health insurance in Iran. Global journal of health science, 6(5), 154.##22. Nosratnejad, S., Rashidian, A., Sari, A. A., & Moradi, N. (2017). Willingness to pay for complementary health care insurance in Iran. Iranian journal of public health, 46(9), 1247.##23. O'Brien, B., & Viramontes, J. L. (1994). Willingness to pay: a valid and reliable measure of health state preference?. Medical Decision Making, 14(3), 289-297.##24. Report of the National Health Research Institute of the Islamic Republic of Iran, (2018), "Universal health coverage in an active state, challenges, strategies".##25. Sales, R. K., Reyes, G. K., Ting, T., & Salvador Jr, D. (2020). Factors that affect social health insurance enrollment and retention of the informal sector in the Philippines: a qualitative study.##26. Thornton, R. L., Hatt, L. E., Field, E. M., Islam, M., Solís Diaz, F., & González, M. A. (2010). Social security health insurance for the informal sector in Nicaragua: a randomized evaluation. Health economics, 19(S1), 181-206.##27. Witati, W., & Putri, P. I. (2020). Determinant of Willingness to Pay Health Insurance Contribution to Informal Workers. Economics Development Analysis Journal, 9(2), 144-158. ##

برآورد منابع و مصارف سازمان تأمین اجتماعی تا سال 1430 بر اساس تحولات جمعیت Estimation of Resources and Expenses of Social Security Organization Until 2050 Based on Population Changes 1 1 مقدمه: فزونی مصارف بر منابع تأمین اجتماعی یکی از چالش‌های اقتصادی کشور می باشد. از آنجاییکه ساختار جمعیت و پویایی آن در هر کشوری، محور و مرکز برنامه‌ریزی اقتصادی و اجتماعی محسوب می‌شود از طرفی این افزایش جمعیت مستلزم اطمینان خاطر از رفاه و آرامش در آینده است. بنابراین برنامه ریزی و پیش‌بینی تأثیر تحولات جمعیتی بر منابع و مصارف سازمان تأمین اجتماعی تا سال ۱۴۳۰ از اهمیت بسزایی برخوردار است. روش بررسی: در این مطالعه، تخمین زدن جمعیت بر اساس گروه‌های سنی با استفاده از روش کوهورت تا سال ۱۴۳۰ انجام شده و سپس تقاضا و عرضه نیروی کار در چهار سناریو مختلف تا سال ۱۴۳۰ پیش‌بینی شده است. با بهره‌گیری از نسبت میانگین بیمه‌شدگان به شاغلین، تعداد بیمه‌شدگان نیز تا سال ۱۴۳۰ پیش‌بینی شده است. برای تعیین تعداد مستمری‌بگیران، از نسبت مستمری‌بگیران به تعداد افراد بالای ۶۰ سال استفاده و با حفظ ثبات این رابطه، تعداد مستمری‌بگیران تا سال ۱۴۳۰ تخمین زده شده است. یافته ها:  یکی از سناریوها، که احتمال وقوع آن نیز بالاست، نشان می‌دهد که از سال ۱۴۱۵، شکاف بین هزینه و درآمد سازمان تأمین اجتماعی بیشتر می‌شود. سناریوی دیگر نیز سال مذکور را ۱۴۲۰به عنوان زمانی مهم برای این شکاف تعیین می‌کند. نتایج این پژوهش نشان می‌دهد که تا سال ۱۴۳۰، مصارف سازمان تأمین اجتماعی به میزان حدود ۱۴۰۱۶ هزار میلیارد تومان از منابع آن بیشتر خواهد بود. نتیجه‌گیری: روند منابع و مصارف سازمان تأمین اجتماعی با استناد به سناریوی واقع بینانه که احتمال وقوع آن بالاتر از سایر سناریوها است نشان می‌دهد که تا سال ۱۴۱۵ منابع سازمان تأمین اجتماعی بیشتر از مصارف آن است و مازاد وجود دارد. در سال ۱۴۱۵ منابع و مصارف برابر می شود و کسری وجود ندارد. از سال۱۴۱۵ به بعد شکاف منابع و مصارف به نفع مصارف در حال افزایش می‌باشد. 2 Introduction: Increasing spending on social security resources is one of the country's economic challenges. Since the population structure and its dynamics in any country is considered the axis and center of economic and social planning, on the other hand, this increase in population requires the assurance of prosperity and peace in the future. Therefore, planning and predicting the impact of demographic changes on the resources and expenses of the social security organization until 2050 is of great importance. Methods: In this research, the estimation of the population based on age groups using the cohort method has been done until 2050, and then the demand and supply of labor in four different scenarios has been predicted until 2050. Using the average ratio of insured persons to employed persons, the number of insured persons has been predicted until 2050. To determine the number of pensioners, the ratio of pensioners to the number of people over 60 years of age is used, and by maintaining the stability of this relationship, the number of pensioners has been estimated until 2050. Results: One of the scenarios, which is highly likely to happen, shows that since 2035, the gap between the cost and income of the social security organization will increase. Another scenario determines the mentioned year 2040 as an important time for this gap. The results of this research show that by 2050, the expenses of the social security organization will exceed its resources by about 14,016 thousand billion tomans. Conclusion: The trend of social security organization's resources and expenses, based on a realistic scenario, which is more likely than other scenarios, shows that until 1415, the social security organization's resources are more than its expenses and there is a surplus. In 2035, resources and expenses are equal and there is no deficit. From 2035 onwards, the gap between resources and expenses is increasing in favor of expenses. 50 61 2024/04/212024/01/32024/02/262024/01/72024/02/22024/01/7 1402/10/17 2024/05/142024/04/252024/05/182024/03/162024/05/122024/05/19 1403/2/30 امیر حلاجی Amir Hallaji گروه علوم اقتصادی، واحد فیروزکوه، دانشگاه آزاد اسلامی، فیروزکوه، ایران amirhallaji1979@gmail.com صالح قویدل دوستکوئی Saleh Ghavidel Doostkouei گروه علوم اقتصادی، واحد فیروزکوه، دانشگاه آزاد اسلامی، فیروزکوه، ایران salehghavidel421@gmail.com مسعود صوفی مجیدپور Masood Soufi Majidpour گروه علوم اقتصادی، واحد فیروزکوه، دانشگاه آزاد اسلامی، فیروزکوه، ایران masoodsoufi@gmail.com علی‌عباس حیدری Aliabbas Heydari گروه علوم اقتصادی، واحد فیروزکوه، دانشگاه آزاد اسلامی، فیروزکوه، ایران aliabbas_heidari@yahoo.com Resources and Expenses Financing Labor Supply Participation Rate Retirement Insurance Calculations منابع و مصارف تأمین مالی عرضه نیروی کار نرخ مشارکت بازنشستگی محاسبات بیمه‌ای ## ##

بررسی روند رشد تولیدات علمی حوزه بیمه سلامت در ایران و جهان طی دو دهه اخیر Investigating the Growth Trend of Health Insurance Scientific Productions in Iran and the World During the Last Two Decades 1 1 مقدمه: تعداد انتشارات علمی، مهمترین شــاخص کمی توسعه و پیشرفت هر کشور محسوب می شــود. هدف از مطالعه حاضر بررسی روند رشد تولیدات علمی حوزه بیمه سلامت در ایران و جهان طی دو دهه اخیر است. روش بررسی: پژوهش حاضر یک مطالعه کمی با رویکرد علم سنجی بود. در تدوین استراتژی جستجو، معیارهای مشخصی برای استخراج مقالات در پایگاه اسکوپوس درنظر گرفته شد که شامل: تاریخ انتشار (۲۰۰۰-۲۰۲۴)، اصالت علمی یافته‌ها (اورجینال بودن مقاله)، حضور کلیدواژه‌های اصلی بیمه سلامت در عنوان یا کلیدواژه مقاله بود. به منظور توصیف وضعیت انتشار مقالات حوزه بیمه سلامت از شاخص‌های پراکندگی و آنالیز روند در نرم افزار اکسل ۲۰۱۷ استفاده شد. یافته‌ها: انتشارات علمی در حوزه بیمه سلامت از یک روند صعودی به‌صورت یک تابع چندجمله ایی با درجه ۲ تبعیت می نماید (R۲=۰.۹۶). ایالات متحده با انتشار ۴۶ درصد مقالات حوزه بیمه سلامت با اختلاف قابل توجهی نسبت به سایر کشور ها بیشترین تولیدات علمی را در حوزه بیمه سلامت داشت. بعد از آن کشور آلمان با ۵ درصد و کشور انگلستان با ۳ درصد بیشترین سهم را در انتشار مقالات داشتند. ایران از نظر تعداد مقالات حوزه بیمه سلامت در رتبه ۲۰ قرار داشت. نتیجه‌گیری: پوشش همگانی بیمه سلامت در ایران ظرفیت خوبی برای انتشار تجربیات این حوزه در ایران فراهم می‌نماید، با برنامه‌ریزی دقیق و ظرفیت‌های علمی موجود، انتشار تجربیات مرتبط با موضوع بیمه سلامت ارتقا می‌یابد. 2 Introduction: The number of scientific publications is the most important quantitative indicator of the development and progress of any country. The purpose of this study is to investigate the growth trend of scientific productions in the field of health insurance in Iran and the world during the last two decades. Methods: The present study was a quantitative and applied study with a scientometric approach. Certain criteria were considered for extracting articles in the Scopus database, which included: publication date (2000-2024), scientific originality of the findings (originality of the article), the presence of the main keywords of health insurance in the title or keyword of the article. In order to describe the publication status of health insurance articles, dispersion indices and trend analysis were used in Excel 2017 software. Results: Scientific publications in the field of health insurance follow an upward trend as a polynomial function with degree 2 (R2=0.96). The United States published 46% of articles in the field of health insurance, with a significant difference compared to other countries. After that, Germany with 5% and England with 3% contributed the most in publishing articles. In terms of the number of articles, Iran was ranked 201st. Conclusion: Universal coverage of health insurance in Iran provides a good capacity for the dissemination of experiences in this field in Iran, with detailed planning and existing scientific capacities, the dissemination of experiences related to the issue of health insurance will be promoted. 62 71 2024/04/212024/01/32024/02/262024/01/72024/02/22024/01/72024/04/8 1403/1/20 2024/05/142024/04/252024/05/182024/03/162024/05/122024/05/192024/06/5 1403/3/16 مریم یعقوبی Maryam Yaghoubi مرکز ملی تحقیقات بیمه سلامت، تهران، ایران maryamyaghoubi2023@gmail.com محمد مسکرپورامیری Mohammad Meskarpou-Amiri مرکز تحقیقات مدیریت سلامت، دانشگاه علوم پزشکی بقیه ا...(عج)، تهران، ایران mailer.amiri@gmail.com Bibliometrics Scientific Products Health Insurance Iran کتاب سنجی تولیدات علمی بیمه سلامت ایران ## ##

بررسی چالش‌های نسخه‌نویسی الکترونیک پزشکان شهرستان اهواز در سال 1402 Investigating the Challenges of Electronic Prescribing for Physicians in Ahvaz County in 2024 1 1 مقدمه: نسخه نویسی الکترونیکی با اولین کاربرد آن در مراقبت‌های سرپایی در بسیاری از کشورها اجرا شده است. در ایران دو سالی است که نسخه‌نویسی الکترونیکی با جدیت اجرا می‌شود و در حالی که در برخی مناطق موفقیت آمیز بوده، با چالش‌هایی نیز مواجه شده است. شناسایی این چالش‌ها و تعیین علل آن‌ها نه تنها می‌تواند به رفع مشکلاتی که پزشکان با آن روبه‌رو هستند کمک کند، بلکه کمک قابل توجهی به بهبود برنامه نسخه‌نویسی الکترونیکی می‌کند. پژوهش حاضر با هدف بررسی چالش های پیش روی پزشکان در امر تجویز الکترونیکی در شهرستان اهواز در سال ۱۴۰۲ انجام شد. روش بررسی: این مطالعه کیفی در سال ۱۴۰۲ در شهرستان اهواز، استان خوزستان، با جمعیت پزشک انجام شد. شرکت‌کنندگان ۳۳ نفر بودند که به روش نمونه‌گیری هدفمند انتخاب شدند. روش‌های جمع‌آوری داده‌ها شامل مصاحبه‌های نیمه ساختاریافته با پزشکان، یادداشت‌های میدانی و ثبت یادآوری بر اساس اصل اشباع داده‌ها بود. یافته‌ها: فرآیند تحلیل داده‌ها چهار مضمون اصلی (ناهماهنگی در کدگذاری دارو، عدم امنیت در سیستم‌های نسخه الکترونیکی، نبود مقررات قانونی و عدم پذیرش نسخه الکترونیک توسط پزشکان) و ۱۱ طبقه (تناسب برخی کدها، کدهای تکراری، تفاوت در نوع ثبت دارو، عدم وجود کد برای برخی داروها، عدم هماهنگی بیمه‌گذاران، عوامل مرتبط با سازمان‌های بیمه‌گر، ناهماهنگی اطلاعات بیمار) و ۲۱ زیرطبقه حاصل شد. نتیجه‌گیری: پزشکان به دلایل مختلفی از جمله ناهماهنگی سیستم‌های بیمه‌ای در کدگذاری داروها، استفاده از نسخه‌های مختلف توسط سازمان های بیمه‌گر، عدم ادغام سیستم بیمه و داروخانه، قطعی مکرر اینترنت، عدم هماهنگی بین داروخانه‌ها و ... با چالش‌های متعددی روبرو هستند. پزشکان، تجویز بیش از حد یا نادرست دارو توسط برخی داروخانه‌ها. رفع این چالش‌ها می‌تواند زمینه‌ساز موفقیت طرح نسخه نویسی الکترونیک در اهواز باشد. 2 Introduction: Electronic prescribing has been implemented in many countries, with its first application in outpatient care. In Iran, electronic prescribing has been seriously implemented for two years now, and while it has been successful in some regions, it has also faced challenges. Identifying these challenges and determining their causes can not only help address the problems faced by physicians but also significantly contribute to the improvement of the electronic prescribing program. The present study aimed to investigate the challenges faced by physicians in electronic prescribing in Ahvaz County in 2024. Methods: This qualitative study was conducted in Ahvaz County, Khuzestan Province, Iran, in 2024, with a population of physicians. Participants were 33 individuals selected using a purposive sampling method. Data collection methods included semi-structured interviews with physicians, field notes, and recording reminders based on the principle of data saturation. Results: The data analysis process yielded four main themes (inconsistencies in drug coding, lack of security in electronic prescription systems, lack of legal regulations and non-acceptance of electronic prescribing by physicians) and 11 categories (inconsistency of some codes, duplicate codes, differences in the type of registration of a drug, absence of some codes for some drugs, lack of coordination between insurers, factors related to insurance organizations, inconsistency of patient information) and 21 subcategories. Conclusion: Physicians face numerous challenges due to various reasons, such as inconsistencies in insurance systems in drug coding, the use of different prescriptions by insurance organizations, the lack of integration between insurance and pharmacy systems, frequent internet outages, lack of coordination between pharmacies and physicians, excessive or incorrect drug dispensing by some pharmacies. Addressing these challenges can pave the way for the success of the electronic prescribing program in Ahvaz. 72 78 2024/04/212024/01/32024/02/262024/01/72024/02/22024/01/72024/04/82024/04/18 1403/1/30 2024/05/142024/04/252024/05/182024/03/162024/05/122024/05/192024/06/52024/06/1 1403/3/12 زینب بنی‌سعید Zainab Bani Saeed گروه مدیریت بهداشتی و درمانی، واحد مرودشت، دانشگاه آزاد اسلامی، شیراز، ایران عباس یزدان‌پناه Abbas Yazdanpanah گروه مدیریت بهداشتی و درمانی، واحد مرودشت، دانشگاه آزاد اسلامی، شیراز، ایران abbas_yaz@yahoo.com Challenges Electronic Prescribing Physicians Ahvaz چالش‌ها نسخه‌نویسی الکترونیک پزشکان اهواز 1.guyen PA, Syed-Abdul S, Iqbal U, Hsu MH, Huang CL, Li HC, et al. A probabilistic model for reducing medication errors. PLoS One 2013; 8(12): e82401.##2. Horsky J, Phansalkar S, Desai A, Bell D, Middleton B. Design of decision support interventions for medication prescribing. Int J Med Inform 2013; 82(6): 492-503.##3. Walsh KE, Landrigan CP, Adams WG, Vinci RJ, Chessare JB, Cooper MR, et al. Effect of computer order entry on prevention of serious medication errors in hospitalized children. Pediatrics 2008; 121(3): e421-e427.##4.Salmivalli L, Hilmola OP. Business pluralism of electronic prescriptions: state of development in Europe and the USA. Int J Electron Healthc 2006; 2(2): 132-48.##5. Salmivalli L, Hypponen H, Nykanen P, Ruotsalainen P, Pajukoski M. Testing a theoretical framework for interdisciplinary IT evaluation: The case of Finnish Electronic Prescription. International Journal of Healthcare Technology and Management 2007; 8(1-2): 42-65.##6. Salmon JW, Jiang R. E-prescribing: History, issues, and potentials. Online J Public Health Inform 2012; 4(3): 4304.##7. Lipton HL, Miller RH, Wimbush JJ. Electronic prescribing: Ready for prime time? J Healthc Inf Manag 2003; 17(4): 72-9.##8. Moniz TT, Seger AC, Keohane CA, Seger DL, Bates DW, Rothschild JM. Addition of electronic prescription transmission to computerized prescriber order entry: Effect on dispensing errors in community pharmacies. Am J Health Syst Pharm 2011; 68(2): 158-63.##9. Tan WS, Phang JS, Tan LK. Evaluating user satisfaction with an electronic prescription system in a primary care group. Ann Acad Med Singapore 2009; 38(6): 494-7.##10. Samadbeik M, Ahmadi M. Electronic prescription system: Concepts and standards (Narrative review article). Health Inf Manage 2013; 10(2): 312-24.##11.Fischer SH, Rudin RS, Shi Y, Shekelle P, Amill-Rosario A, Scanlon D, et al. Trends in the use of computerized physician order entry by health-system affiliated ambulatory clinics in the United States, 2014–2016. BMC Health Serv Res. 2020;20(1):1-6.##12. Cresswell KM, Lee L, Slee A, Coleman J, Bates DW, Sheikh A. Qualitative analysis of vendor discussions on the procurement of computerised physician order entry and clinical decision support systems in hospitals. BMJ Open. 2015;5(10):1-10.##13. Gall W, Aly A-F, Sojer R, Spahni S, Ammenwerth E. The national e-medication approaches in Germany, Switzerland and Austria: A structured comparison. Int J Med Inform. 2016;93:14-25.##14.Raeesi A, Abbasi R, Khajouei R. Evaluating physicians’ perspectives on the efficiency and effectiveness of the electronic prescribing system. Int J Technol Assess Health Care. 2021;37(1):1-7.##15.Peikari HR, Shah MH, Zakaria MS, Yasin NM, Elhissi A. The impacts of second generation e-prescribing usability on community pharmacists outcomes. Res Social Adm Pharm. 2015;11(3):339-51.##16. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness’. Nurse Educ Today. 2004; 24(2):105-12.##17. Cypress BS. Rigor or reliability and validity in qualitative research: Perspectives, strategies, reconceptualization, and recommendations. Dimens Crit Care Nurs. 2017; 36(4):253-63.##18.Jebraeily M, Rashidi A, Mohitmafi T, Muossazadeh R. Evaluation of Outpatient Electronic Prescription System Capabilities from the Perspective of Physicians in Specialized Polyclinics of Urmia Social Security Organization. Payavard Salamat. 2021 Jan 10;14(6):557-68.##19.Akbari A, Rashidi Z, Fatemeh Walipour Babli. The challenges of using electronic prescribing, the third conference on information technology and health promotion with a focus on nursing, Tehran, https://civilica.com/doc/1158681.1399.##20.Oktarlina RZ. E-prescribing: benefit, barrier, and adopting challenge in electronic prescribing. Journal of Medicine. 2020 Jul 1;21(2):98.##21.Alinejhad A, Nourani A, Jebraeily M. Usability evaluation of the user interface in electronic prescribing systems of Iran health insurance organization and social security organization. Journal of Health Administration. 2022 Jul 10;25(2):78-94.##22.Ghasemian M, Gharibi A, Dashtizadeh A, Ghanbari Shandiz K., Examining the challenges of using electronic prescribing in courthouses, a review study, the 5th conference on information technology and health promotion focusing on remote health, https://civilica.com /doc/1765441 1401.##23.Alavi R, Kazemnejad A, Sheikh Taheri A. Physicians' and pharmacists' views on ambulatory electronic prescribing. Journal of Health Administration. 2022 Oct 1;25(3).##24.Tan T, Chan S, Ind M, Pace G, Bailey J, Reed K, Dutton T, Osuagwu UL, Wong KC. Benefits and challenges of electronic prescribing for general practitioners and pharmacists in regional Australia. Australian Journal of Rural Health. 2023 May 27.##25.Hareem A, Lee J, Stupans I, Park A, Wang K. Benefits and barriers associated with e-prescribing in community pharmacy–A systematic review. 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A probabilistic model for reducing medication errors. PLoS One 2013; 8(12): e82401.##2. Horsky J, Phansalkar S, Desai A, Bell D, Middleton B. Design of decision support interventions for medication prescribing. Int J Med Inform 2013; 82(6): 492-503.##3. Walsh KE, Landrigan CP, Adams WG, Vinci RJ, Chessare JB, Cooper MR, et al. Effect of computer order entry on prevention of serious medication errors in hospitalized children. Pediatrics 2008; 121(3): e421-e427.##4.Salmivalli L, Hilmola OP. Business pluralism of electronic prescriptions: state of development in Europe and the USA. Int J Electron Healthc 2006; 2(2): 132-48.##5. Salmivalli L, Hypponen H, Nykanen P, Ruotsalainen P, Pajukoski M. Testing a theoretical framework for interdisciplinary IT evaluation: The case of Finnish Electronic Prescription. International Journal of Healthcare Technology and Management 2007; 8(1-2): 42-65.##6. Salmon JW, Jiang R. E-prescribing: History, issues, and potentials. 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