National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 7 1 2024 6 1 Is the Cheapening of Health Services an Unattainable Wish? 1 3 FA Aliakbar Haghdoost Research Center for HIV Care and Sexually Transmitted Infections, Future Research Institute in Health, Kerman University of Medical Sciences, Kerman, Iran

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 7 1 2024 6 1 Induced Demand of Providers of Diagnostic and Therapeutic Services in the World; Scoping Review 4 13 FA Azamsadat Rivandi Department of Health Care Management, Faculty of Health, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran Khalil Alimohammadzadeh Department of Health Care Management, Faculty of Health, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran Sara Emamgholipour Sefiddashti Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Ali Maher Health Policy Economics and Management Department, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Amin Ghasem Begloo Department of Health Care Management, Faculty of Health, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran 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.

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 7 1 2024 6 1 Evaluating the Satisfaction and Applicability of Business Intelligence (BI) in Iran Health Insurance Organization 14 21 FA Amir Hossein Habibian Department of Management, Payame Noor University of Tehran Province, Tehran, Iran Amir Houshang Tajfar Department of Management, Payame Noor University of Tehran Province, Tehran, Iran Mohammadreza Jamali National Center for Health Insurance Research, Tehran, Iran 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.

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 7 1 2024 6 1 Performance Evaluation Indicators of Iran Health Insurance Organization Based on Macro Policies 22 41 FA Efat Mohamadi Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran Ahad Bakhtiari Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran Mohammad Mehdi Nasehi National Center for Health Insurance Research, Tehran, Iran Mohammad Effatpanah National Center for Health Insurance Research, Tehran, Iran Mehdi Rezaei National Center for Health Insurance Research, Tehran, Iran Zahra Shahali National Center for Health Insurance Research, Tehran, Iran Amirhossein Takian Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran Alireza Olyaeemanesh Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran 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.

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 7 1 2024 6 1 Willingness to Pay of Informal Job Workers for Health Insurance in Isfahan City, Iran 42 49 FA Mansour Askary Department of Economics‚ Khomeinishahr Branch, Islamic Azad University, Khomeinishahr/Isfahan, Iran Mostafa Rajabi Department of Economics‚ Khomeinishahr Branch, Islamic Azad University, Khomeinishahr/Isfahan, Iran Sharam Tofighi Department of Future Studies and Theory Building, Iranian Academy of Medical Sciences, Tehran, Iran Maryam Sharifdoust Department of Statistics, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr/Isfahan, Iran Bahar Hafezi Department of Economics‚ Khomeinishahr Branch, Islamic Azad University, Khomeinishahr/Isfahan, Iran 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.

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 7 1 2024 6 1 Estimation of Resources and Expenses of Social Security Organization Until 2050 Based on Population Changes 50 61 FA Amir Hallaji Department of Economics, Firuzkuh Branch, Islamic Azad University, Firuzkuh, Iran Saleh Ghavidel Doostkouei Department of Economics, Firuzkuh Branch, Islamic Azad University, Firuzkuh, Iran Masood Soufi Majidpour Department of Economics, Firuzkuh Branch, Islamic Azad University, Firuzkuh, Iran Aliabbas Heydari Department of Economics, Firuzkuh Branch, Islamic Azad University, Firuzkuh, Iran 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.

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 7 1 2024 6 1 Investigating the Growth Trend of Health Insurance Scientific Productions in Iran and the World During the Last Two Decades 62 71 FA Maryam Yaghoubi National Center for Health Insurance, Tehran, Iran Mohammad Meskarpou-Amiri Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran 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.

National Center for Health Insurance Research Iranian Journal of Health Insurance 2645-8225 7 1 2024 6 1 Investigating the Challenges of Electronic Prescribing for Physicians in Ahvaz County in 2024 72 78 FA Zainab Bani Saeed Health Management Department, Islamic Azad University, Marvdasht Branch, Shiraz, Iran Abbas Yazdanpanah Health Management Department, Islamic Azad University, Marvdasht Branch, Shiraz, Iran 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.