Rethinking the health services insurance system: a new model for Iranian railroad households

During 1995 and 1996, a 10% stratified random sample of 2124 people representing permanent Iranian railroad workers in 12 provinces was selected to survey the use of health services by personnel and their families. Data were collected from 2107 workers through interviews using a structured questionnaire. The objective was to determine demographic and health characteristics and user satisfaction in order to improve the present delivery of the health insurance system. A new plan for the delivery of health insurance, which focuses upon social accountability and community orientation and is based on the roles of family doctors and nurses in railroad health posts, is proposed and evaluated.