A qualitative study of the difficulties in reaching sustainable universal health insurance coverage in Iran

作者：Ibrahimipour Hossein; Maleki Mohammad Reza; Brown Richard; Gohari Mohammadreza; Karimi Iraj; Dehnavieh Reza^*

来源：Health Policy and Planning, 2011, 26(6): 485-495.

DOI：10.1093/heapol/czq084

• Health insurance
• universal coverage
• Iran
• population coverage
• sustainable financing
• benefit package

Objective To understand the Iranian health financing system and provide lessons for policy makers about achieving universal coverage.
Methods Twenty-five interviewees from seven major health insurance companies were selected for a qualitative study in 2007. Using a semi-structured interview, three main tasks of the health financing system (revenue collection, risk pooling and purchasing) were investigated. A framework method was applied for the data analysis.
Results The results of the study show the following seven major obstacles to universal coverage: unknown insured rate; regressive financing and non-transparent financial flow; fragmented and non-compulsory system; non-scientifically designed benefit package; non-health-oriented and expensive payment system; uncontrolled demands; and administrative deficiency. A long-term systematic plan is required to address the above problems.

• 出版日期2011-11