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Empowering the insured under health insurance: a case study in center of Iran

Empowering the insured under health insurance: a case study in center of Iran PurposeCurrently, the health system is a treatment-oriented system focused on service providers. In this system, the main focus is on the health market, with little attention on insured. One way to get out of existing conditions is to empower the insured in order to involve them actively in maintaining and improving health. The paper aims to discuss these issues.Design/methodology/approachThis qualitative study was done using the content analysis method. Based on the purposive sampling method and theoretical saturation criterion, 24 individuals including 12 health insurance experts and 12 insured participated in the study in 2018. The semi-structured interview method was used to collect data. Data were analyzed using MAXQDA10 software.FindingsHaving analyzed the interviews, 750 codes were obtained. These codes were categorized into two categories of “insurance experts” and “insured” and ten subcategories of “informing and educating, cost reduction, intersectional activities, expectations from the insured, services package, access to services, inability to pay costs, participation, and expectations from the insurance organization.”Originality/valueThis qualitative study was conducted to assess and determine the effective strategies for empowering the insured under health insurance. The results of this study are helpful to the health insurance organizations and health decision makers to detect the effective ways to develop the quality of insurance services, improve the status of insured, and increase access to health care goods and services. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Human Rights in Healthcare Emerald Publishing

Empowering the insured under health insurance: a case study in center of Iran

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Publisher
Emerald Publishing
Copyright
Copyright © Emerald Group Publishing Limited
ISSN
2056-4902
DOI
10.1108/IJHRH-04-2019-0029
Publisher site
See Article on Publisher Site

Abstract

PurposeCurrently, the health system is a treatment-oriented system focused on service providers. In this system, the main focus is on the health market, with little attention on insured. One way to get out of existing conditions is to empower the insured in order to involve them actively in maintaining and improving health. The paper aims to discuss these issues.Design/methodology/approachThis qualitative study was done using the content analysis method. Based on the purposive sampling method and theoretical saturation criterion, 24 individuals including 12 health insurance experts and 12 insured participated in the study in 2018. The semi-structured interview method was used to collect data. Data were analyzed using MAXQDA10 software.FindingsHaving analyzed the interviews, 750 codes were obtained. These codes were categorized into two categories of “insurance experts” and “insured” and ten subcategories of “informing and educating, cost reduction, intersectional activities, expectations from the insured, services package, access to services, inability to pay costs, participation, and expectations from the insurance organization.”Originality/valueThis qualitative study was conducted to assess and determine the effective strategies for empowering the insured under health insurance. The results of this study are helpful to the health insurance organizations and health decision makers to detect the effective ways to develop the quality of insurance services, improve the status of insured, and increase access to health care goods and services.

Journal

International Journal of Human Rights in HealthcareEmerald Publishing

Published: Nov 28, 2019

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