ارزیابی وضعیت ترکیب تأمین مالی و ارائه مراقبت‌ها در نظام بیمه اجتماعی درمان در ایران

 Background and Objective: The aim of the present study was assessment of the status of combination of financing and providing services in Medical Service Insurance Organization (MSIO) as unique provider. Materials and Methods: Present study was an applied study that was performed in a descriptive-analytical and statistical manner. The research population consisted of all Medical Service Insurance Organization’s (MSIO’s) insured and total services delivered to them. In this study, the time comparison of correlation coefficient in estimation regression of exponential function in two times 2005 and 2009 was used. Comparison of changes in residuals distribution was used for determination of changes in province’s situation. Finally, the Eviews econometrics software was used for estimation regression. Results: This study showed that in provinces of country, the effect of per capital care received by insured on per capital cost pay by insurance organization significantly reduced from 0.25 in 2005 to 0.14 in 2009 (p<0.05). Also, with regard to changes in relative situation of provinces in these periods of time, 8 provinces have worse situation because did not tend to combination of per capital cost and per capital refers as unique production and in situation of 16 provinces did not take place noticeable changes. Conclusion: It seems that after about two decades from policy of developing social health insurance (SHI) in Iran, the financing and services delivery system through role of social health insurances could not be able for making it possible to combine financing and services delivery as unique production for insurers.