Nazari Aslan, Masoudi Asl Iravan, Abolhallaje Masoud, Nasiripour Amir Ashkan, Kabir Mohammad Javad
Department of Health Services Management, Science and Research Branch, Islamic Azad University, Tehran, Iran.
Department of Health Services Management, School of Health Management and Information Sciences, Iran university of medical sciences, Tehran, Iran.
Med J Islam Repub Iran. 2018 Aug 26;32:77. doi: 10.14196/mjiri.32.77. eCollection 2018.
Social health insurances provide protection to access affordable coverage of services and stewardships of health system need to intervene to fulfill these objectives. This study conducted to assess interaction between stewardship and social health insurances. This qualitative study conducted in two phases as comparative study and document analysis in 2018. Comparative study employed to identify the dimensions and requirements of interaction between stewardship of health systems and social health insurances in countries around the world. In document analysis, all evidence about Iran health financing reviewed. Data extraction forms were used to gather data. There were less interaction between stewardship and social health insurances in revenue collection and risk pooling. Advisory role of stewardship and proposals to coverage of uninsured people and performing risk analysis were some examples of such interaction. In Iran's health system, where stewardship plays a magnificent role in service provision, the basis of interactions are contracts, payment systems and timeline of payments. Mechanisms of interaction in Iran is not clear or does not work properly. Thus, nonstructural merging of social health insurances needs to redefine these mechanisms.
社会医疗保险为获得可负担的服务覆盖提供保障,而卫生系统的管理需要进行干预以实现这些目标。本研究旨在评估管理与社会医疗保险之间的相互作用。这项定性研究于2018年分两个阶段进行,包括比较研究和文献分析。比较研究用于确定世界各国卫生系统管理与社会医疗保险之间相互作用的维度和要求。在文献分析中,对伊朗卫生筹资的所有证据进行了审查。使用数据提取表来收集数据。在收入筹集和风险分担方面,管理与社会医疗保险之间的相互作用较少。管理的咨询作用以及关于覆盖未参保人群和进行风险分析的提议就是这种相互作用的一些例子。在伊朗卫生系统中,管理在服务提供方面发挥着重要作用,相互作用的基础是合同、支付系统和支付时间线。伊朗的相互作用机制不明确或运行不畅。因此,社会医疗保险的非结构性合并需要重新定义这些机制。