探索伊朗通过补充保险覆盖牙科服务的挑战:质量研究
Zahra Pouraskari1, Reza Yazdani1,2, Hossein Hessari1,2
1Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
International journal of dentistry
|March 19, 2024
概括
在伊朗,用补充保险覆盖牙科服务面临高成本和服务限制. 解决方案需要保险部门之间的协作,统一的信息系统和风险调整保费.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 保险研究 保险研究
背景情况:
- 金融保护对于普及医疗覆盖是必不可少的.
- 将昂贵的牙科服务纳入保险计划对利益相关者提出了挑战.
- 本研究探讨了伊朗通过补充保险覆盖牙科服务的挑战.
研究的目的:
- 探索与伊朗补充牙科保险覆盖相关的挑战.
- 确定政策制定者,保险公司,提供商和保单持有人面临的关键问题.
- 通过保险为改善牙科服务可访问性的策略提供信息.
主要方法:
- 在伊朗进行的定性研究 (2020-2021年).
- 方法的三角化,包括深入的半结构面试和文档审查.
- 根据26次采访和9份国家文件的数据进行了框架分析.
主要成果:
- 六个主要主题出现了:保险承诺/服务覆盖,报销,信息系统,经济问题,人口覆盖和监管.
- 牙科服务的高成本是我们发现的最重要的挑战.
- 保险承诺和服务覆盖范围的限制也是一个突出的问题.
结论:
- 伊朗的补充牙科保险面临着经济和服务覆盖的障碍.
- 基本和补充保险部门之间的合作至关重要.
- 开发一个统一的信息系统和实施风险调整保费是推的解决方案.
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