Legal and policy requirements of basic health insurance package to achieve universal health coverage in a developing country

BMC Research Notes

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[1] 0000 0000 8819 4698, grid.412571.4, Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran;0000 0000 8819 4698, grid.412571.4, Student Research Committee, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran;0000 0004 0385 452X, grid.412237.1, Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran;0000 0004 0418 0096, grid.411747.0, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgān, Iran;0000 0004 0612 272X, grid.415814.d, Secretariat for Supreme Council of Health and Food Security, Ministry of Health and Medical Education, Tehran, Iran;

关键词: Universal health coverage;    Legal requirements;    Basic health insurance package;    Document analysis;    Iran;   

DOI  :  10.1186/s13104-019-4618-0

来源: publisher

【 摘 要 】

ObjectivesThis study has analyzed the policy-making requirements related to basic health insurance package at the national level with a systematic view.ResultsAll the documents presented since the enactment of universal health insurance in Iran from 1994 to 2017 were included applying Scott method for assuring meaningfulness, authenticity, credibility and representativeness. Then, content analysis was conducted applying MAXQDA10. The legal and policy requirements related to basic health insurance package were summarized into three main themes and 11 subthemes. The main themes include three kinds of requirements at three level of third party insurer, health care provider and citizen/population that contains 5 (financing insurance package, organizational structure, tariffing and purchasing the benefit packages and integration of policies and precedents), 4 (determining the necessities, provision of services, rules relating to implementation and covered services) and 2 (expanded coverage of population and insurance premiums) sub themes respectively. According to the results, Iranian policy makers should notice three axes of third party insurers, health providers and population of the country to prepare an appropriate basic benefit package based on local needs for all the people that can access with no financial barriers in order to be sure of achieving UHC.

【 授权许可】

CC BY