Identification and Prioritization of Health Insurance System Implementation Barriers Based on a Three-Branch Model (Case Study: Zahedan City)

Insurance development is regarded as one of the states’ solutions, in particular, democratic and public-oriented states, to attain a sustained healthy community so that all individual’s life dimensions in the community would be sheltered by insurance generalization and development. The purpose of the present research is to identify and prioritize barriers to health insurance system implementation based on a three-branch model in three structural, contextual, and behavioral dimensions. The present research methodology is an exploratory-based qualitative-quantitative approach. Research qualitative statistical population includes 30 experts of social security insurance of Zahedan, by interviewing with whom research data was collected. Then, using theme analysis method, interview contents were analyzed, in which three barriers’ sub-dimensions were identified; and then, factors were ranked using analytical hierarchy process (AHP) through Expert choice software. AHP results show that the test inconsistency rate is 0.03, which is less than 0.1 and leads to the reliability of research instrument. In addition, analytical hierarchy process results also demonstrate that the contextual dimensions with the weight of 0.582 are assigned the maximum prioritization followed by structural and behavioral aspects with weights of 0.279 and 0.139, respectively. For quantitative study, 250 questionnaires were randomly distributed among social security insurance staff in Zahedan. Research sample mean test results reveal that from responders’ perspectives all dimensions of behavioral, contextual, and structural barriers influence the health insurance system implementation.