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伊朗健康保险组织下残疾人对康复服务的利用情况。

Utilization of Rehabilitation Services by Disabled People under the Iranian Health Insurance Organization.

作者信息

Arabi Samira, Nasehi Mohammad Mahdi, Shahali Zahra, Shojaee Ali, Dehghani Mohsen, Rezaee Mehdi, Ranjbaran Hossein, Keyhani Parvaneh, Daroudi Rajabali

机构信息

Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Pediatric Neurology Research Center, Research Institute for Child Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Med J Islam Repub Iran. 2025 May 7;39:65. doi: 10.47176/mjiri.39.65. eCollection 2025.

Abstract

BACKGROUND

People with disabilities have greater unmet needs and need health care. These people are acknowledged as a global development priority. This study aimed to investigate the utilization of rehabilitation services by people with disabilities covered by the Iran Health Insurance Organization.

METHODS

This was a cross-sectional descriptive study at the national level. A total of 3676 out of 315,626 insured people with disabilities covered by the Iran Health Insurance Organization were selected from all provinces of the country using a simple random sampling method proportional to the size of the insured population.

RESULTS

A total of 53% of people reported needing rehabilitation services in 2021. Of those requiring rehabilitation services, 51% required physical therapy, 50% occupational therapy, 22% speech therapy, 19% optometry, 13% audiometry, and less than 1% orthotics and prosthetics. Also, only 41% of people who needed rehabilitation services received them. The main reasons for not receiving needed services were financial inability to pay for treatment (76%), physical inability to follow treatment (16%), and the spread of the coronavirus disease 2019 pandemic (8%).

CONCLUSION

The inability to pay fees emerged as the most significant barrier to receiving essential rehabilitation services. Enhancing the financial coverage provided by basic health insurance funds is crucial. Expanding coverage will enable more patients to utilize the rehabilitation services they need, ensuring that financial constraints do not hinder access to vital care. This policy adjustment could be key in increasing the utilization of rehabilitation services and improving overall health outcomes for those in need.

摘要

背景

残疾人有更多未满足的需求且需要医疗保健。这些人被公认为全球发展的优先事项。本研究旨在调查伊朗健康保险组织覆盖的残疾人康复服务利用情况。

方法

这是一项全国性的横断面描述性研究。采用与参保人口规模成比例的简单随机抽样方法,从伊朗健康保险组织覆盖的315626名参保残疾人中,从该国所有省份选取了3676人。

结果

共有53%的人报告在2021年需要康复服务。在需要康复服务的人群中,51%需要物理治疗,50%需要职业治疗,22%需要言语治疗,19%需要验光,13%需要听力测定,而需要矫形器和假肢的不到1%。此外,只有41%需要康复服务的人获得了这些服务。未获得所需服务的主要原因是经济上无力支付治疗费用(76%)、身体上无法接受治疗(16%)以及2019冠状病毒病大流行的影响(8%)。

结论

无力支付费用成为获得基本康复服务的最重大障碍。加强基本医疗保险基金提供的财务覆盖至关重要。扩大覆盖范围将使更多患者能够利用他们所需的康复服务,确保经济限制不会阻碍获得至关重要的护理。这一政策调整可能是提高康复服务利用率和改善有需要者整体健康结果的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40cc/12309314/f75d5b4000b1/mjiri-39-65-g001.jpg

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