Designing Interactional Pattern of Health Financing Between Ministry of Health and Social Health Insurances in Iran

Abstract

Background: Social health insurances are created to achieve public coverage in order to access affordable health care services. Therefore, stewardships of health system should intervene to fulfill these objectives. Objectives: The current study aimed at proposing an interaction pattern between health system and insurances in the field of financing. Methods: A mixed-method study was conducted in two phases from 2017 to 2018. A qualitative interview was employed to identify dimensions and requirements of the interactions in Iran. In the second phase, the extracted items and dimensions were reviewed by experts using Delphi technique and focus-group discussions in two rounds. The data were analyzed by SPSS software version 22 using one-sample t-test. Results: In the qualitative section, two aspects of interaction ways and mechanisms were determined and finally six themes were extracted. In the first round of Delphi, out of 43 extracted items, 12 items were omitted and 31 items achieved the agreement limit. All 31 items were approved by the experts in the second round of Delphi (P < 0.05). Conclusions: Employment of interaction concepts in the field of financing requires a thorough examination of the conditions of each country and it is necessary to create the required infrastructures to achieve the desired situation. Interaction mechanisms of stewardship and social health insurances are not clear in Iran; therefore, creating constituency committees of uniformity is suggested.