Designing an improving model for health insurance development policies in Iran

Today, health insurance has an important role in promoting community health and well-being. In our country, health insurance has shortcomings that are mainly related to policy issues. Therefore, the purpose of this study is to design a model for improving health insurance development policies in Iran.

Methods and Materials:

 The present study is developmental-applied in terms of purpose and is in the group of exploratory mixed research. In the qualitative stage of this research, the theme analysis method was used and in the quantitative stage, structural equation modeling was used. In the qualitative stage, in order to design a research model, 26 academically and executive experts in the field of health insurance who were purposefully selected were interviewed. Also, in a quantitative phase, 186 managers and specialists in the field of health insurance who were randomly selected, were polled with a questionnaire.

Based on the findings, 5 strategies were identified, including promoting macro-management in health insurance, improving insurance services, promoting insurance justice, resource management and using a sustainability approach. Also, the designed model includes variables related to drivers, contextual factors, strategies and consequences. Findings of data analysis by structural equation modeling showed that the components of the research model are approved and all estimated path coefficients are significant.

Finally, the results showed that by providing the interests of stakeholders and also considering all the variables affecting policy-making, it is possible to improve the health insurance policy-making process.