information criteria for basic health insurance package in iran from health insurance organization’s view
نویسندگان
چکیده
introduction: neglecting to define important criteria in developing a basic health insurance package and to notice their real roles will result in defining a package which is politically unacceptable, non-economical, technically inefficient or mixed of them. therefore development of basic health insurance package should be according to appropriate composition of influential criteria. this study was carried out to determining information criteria to define basic health insurance package and their importance. methods: the study was qualitative, descriptive, and cross-sectional, conducted in 2008. at the first stage 20 health insurance experts and involved people were interviewed. at the second stage the notified criteria in these interviews in addition to other criteria, revealed from conceptual study were viewed by experts of iranian basic health insurance companies (52 people). the first stage data were analyzed in atlas-ti and the second stage data were analyzed in spss. results: the revealed criteria from the first stage were classified as 32 criteria in six groups. iranian health insurance experts believed that most important factors involved in defining iranian basic health insurance package were applicability, the view of politic individuals and groups, interventions cost, and patients’ membership in vulnerable patient groups. the study participants indicated cost-effectiveness of services, effectiveness of services, quality of evidence, and equity as the main factors by which the basic health insurance package can be defined appropriately. conclusion: according to results the current influence of some criteria such as the view of politic individuals and groups, and vulnerable patient groups were much more than their appropriate influence in defining iranian basic health insurance package. also some criteria like cost- effectiveness, quality of evidence, long-term sustainability, and safety of manipulations were focused less than what was appropriate for defining the package. according to the results of this study it is suggested that for defining basic health insurance package more appropriately, cost-effectiveness studies should be facilitated and the results of such studies should replace such criteria like the influence of different groups in defining basic health insurance package.
منابع مشابه
Effect of the Health Transformation Plan (HTP) on Implementation Processes, Rules and Regulations of Basic Health Insurance Organizations in Iran
Effect of the Health Transformation Plan (HTP) on Implementation Processes, Rules and Regulations of Basic Health Insurance Organizations in Iran Efat Mohamadi 1, Alireza Oliaeemanesh 1, 2 *, Reza Majd Zade 3, 4, 5, Mohamad Javad Kabir 6, Mojtaba Atri 7, Kamran Asghari 8, Mohammad Reza Mobini Zadeh9, Mosa Tabatabaei 10, Mani Yusefvand 11, Zahra Goudarzi 12 1 Health Equity Research Center, Te...
متن کاملevidence of adverse selection in irans health insurance market
در این تحقیق به مطالعه وجود انتخاب نامساعد(کژ گزینی) در بازار بیمه درمان تکمیلی ایران پرداخته شده است. داده های مورد نیاز توسط پرسشنامه و به روش نمونه گیری خوشه ای جمع آوری شده است. پرسشنامه ها در میان افراد شاغل ساکن شهر تهران توریع شد. در این تحقیق با استفاده از تخمین دو مدل لجستیک و به دست آوردن ضریب همبستگی میان تقاضای بیمه درمان تکمیلی و رخداد خسارت به بررسی موضوع مورد نظر پرداخته شده است....
15 صفحه اولDeveloping attributes and levels for a discrete choice experiment on basic health insurance in Iran
Background: Nonmarket stated preferences valuation, especially discrete choice experiments (DCEs), is one of the commonly used techniques in the health sector. The primary purpose of this approach is to help select attributes and attributes-levels that are able to properly describe health care products or services. This study aimed at developing attributes and attributes-levels for basic health...
متن کاملA Model for settlement of health insurance organizations’ debt to health service delivery institutions
Background: Sukuk is a type of financial instrument backed by balance sheet and physical assets. This applied and descriptive study aimed at providing solutions to the problems faced by insurance companies in the health sector. Methods: In this study, we achieved operational models by reviewing the release nature and mechanism of any of the securities and combin...
متن کاملCompetition between health maintenance organizations and nonintegrated health insurance companies in health insurance markets
This article examines a model of competition between two types of health insurer: Health Maintenance Organizations (HMOs) and nonintegrated insurers. HMOs vertically integrate health care providers and pay them at a competitive price, while nonintegrated health insurers work as indemnity plans and pay the health care providers freely chosen by policyholders at a wholesale price. Such difference...
متن کاملمنابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
مدیریت اطلاعات سلامتجلد ۷، شماره ۲، صفحات ۰-۰
کلمات کلیدی
میزبانی شده توسط پلتفرم ابری doprax.com
copyright © 2015-2023