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Designing The Operational Framework for Development of Health Insurances on the basis of the Health Policies (Article 9 ) issued by the Supreme Leader
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Abstract: (2983 Views) |
Abstract
Introduction: The most important goals of health insurance are to achive Universal Health Coverage (UHC), increase health financing risk protection and fair financial contribution. Therefore, the present study aimed to identifying and prioritizing interventions in order to achieve the upstrime policies to development of health insurance, in 2017.
Method: This study was conducted in two phases and four stages. Initially, qualitative and quantitative health insurance interventions were identified by reviewing the sources and relevant documents and regulations. In the second stage, for the purpose of categorizing and agreeing on the solutions the expert panel was used. In the third stage, necessitated the existence of each of the factors using a self-made questionnaire was evaluated by using the CVR technique. In the fourth stage, the interventions were prioritized using Shannon entropy technique and Simple Additive Weighting (SAW).
Results: The most important prioritized interventions based on the line 7 in Article 9 of the upstrime policy were as follow: to increase the effective services coverage by insuring non-insured individuals and insuring foreigners, supporting patients with rare illness with cooperation of the welfare organization, the establishment of standards and guidelines for the provision of services by basic and supplementary insurance, using the health technology assessment in development of health services benefit package, using rules and regulations for creat the competitive market of supplementary insurance, the modification of the relative value of services through the stakeholders and the introduction of a mix payment system (per capita and rewards) at the first level of service delivery.
Conclusion: In order to implement the proposed interventions in order to achive UHC, this requires a comprehensive interaction between all of stakeholders and Ministry of Health and Medical Education; hence this recommendation will be proposed: creating a comprehensive database and health information system as basic infrastructure, developing a uniqe instruction to pay for providers in order to increase the quality of services and preventing induced demand and finally, the creation of a specialist and expert working group should be considered by policymakers in order to developa basic benefit package based on target groups.
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| Keywords: Health Insurance, Operational Framework, General Health Policies |
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Full-Text [PDF 558 kb]
(594 Downloads)
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Type of Study: Review Article |
Subject:
Special
Received: 2019/05/26 | Accepted: 2019/05/26 | Published: 2019/05/26
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