نوع مقاله : مقاله پژوهشی

نویسندگان

چکیده

مقدمه: ارائه مناسب خدمات سلامت برای ایثارگران، نقش بسیار مهمی در حفظ و رضایت این سرمایه‌های عظیم انسانی و اجتماعی دارد. هدف این پژوهش تعیین مشکلات بیمه درمانی ایثارگران و افراد تحت تکفل آنان در حوزه سلامت بود.مواد و روش: این مطالعه از نوع پژوهش کیفی و با استفاده از تکنیک دلفی در سال 1394 انجام شد. تعداد 30 نفر از نخبگان، مدیران بنیاد شهید و امور ایثارگران مورد مطالعه قرار گرفتند (6 نفر از ستاد بهداشت و درمان، 5 نفر مدیران کل استانی، 14 نفر از معاونان بهداشت و درمان استانها). بعد از جمع‌آوری اطلاعات به دست آمده، با کدبندی و دسته‌بندی اطلاعات، اولویت و مشکلات مربوط به بیمه ایثارگران شناسایی شدند. سپس مضامین و مشکلاتِ شناسایی شده بر اساس نظر شرکت‌کنندگان اولویت‌بندی شد.یافته‌ها: با توجه به نتایج روش دلفی، اولویت و مشکلات اصلی مربوط به بیمه درمانی به ترتیب موضوعات سیاست گذاری بیمه‌ها، مشارکت مالی، پوشش بیمه‌شدگان، مرجع تصمیم گیرنده، سیستم استفاده خدمات، نظارت و ارزیابی و الگوگیری در ارائه خدمات مربوط به سلامتی در ایثارگران بودند.بحث و نتیجه‌گیری: طراحی و اجرای یک نظام بیمه درون سازمانی و مستقل با نام بیمه سلامت ایثارگران و افراد تحت تکفل که مسئولیت خدمات مرتبط با سلامتی این قشر را در قالب خدمات پیشگیری و درمانی انجام دهد، ضروری به نظر می‌رسد.

کلیدواژه‌ها

عنوان مقاله [English]

Assessment of Veterans’ Health Insurance Problems: A Qualitative Research

نویسندگان [English]

  • Gholamreza taebi
  • M Miransari

چکیده [English]

Background and Objectives: Providing adequate health services is regarded as an important key in maintaining and satisfying veterans, as a main human source. This study aimed to identify the problems of veterans’ health insurance in Iran.
Methods: This qualitative study was performed using Delphi technique in 2015. The study population included 30 elite individuals and managers of Martyr Foundation and Veterans Affairs (members of medical committee (n=6), provincial general managers (n=5), and vice-chancellors of health and treatment system in provinces (n=14)). After collecting the data, coding, and classification of information, the priorities and problems of veterans’ insurance were determined. Then, the identified problems and themes were ranked according to the participants’ opinions.
Results: According to the results of Delphi technique, the main problems related to health insurance were policy of insurance, financial contributions, coverage, decision makers, services system, monitoring and evaluation, and modeling in providing health services.
Conclusion: According to the findings, it is necessary to design and implement a system of internal and independent health insurance for veterans that provides prevention and treatment services.

کلیدواژه‌ها [English]

  • Veteran
  • Health insurance
  • Delphi technique
  • Qualitative research
  1. LaVeist TA, Nickerson KJ, Bowie JV. Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients. Medical Care Research and Review. 2000; 57:146-161.
  2. Xie X. Hospitalization Expenses Analysis of Chinese Stroke Patients with Urban Employee Basic Medical Insurance. Value in Health. 2015; 7(18): 385.
  3. Huang F, Gan L. The Impacts of China's Urban Employee Basic Medical Insurance on Healthcare Expenditures and Health Outcomes. Health economics. 2015 Jan 1. http://www.nber.org/papers/w20873.pdf
  4. Kazemipour S. Report of Janbazan satisfaction of medical council. JMERC 2002; 3(1):15-28.
  5. Modirian E, Eskandari A. Veterans’ Satisfaction analysis of Disability rating commission. Iranian Journal of War and Public Health. 2010; 2(2):16-21.
  6. Taghipour H, Moharamzad Y, Mafi AR, Amini A, Naghizadeh MM, Soroush MR, Namavari A. Quality of life among veterans with war-related unilateral lower extremity amputation: a long-term survey in a prosthesis center in Iran. Journal of Orthopedics trauma. 2009; 23(7):525-30.
  7. Aflakseir A, Coleman PG. The influence of religious coping on the mental health of disabled Iranian war veterans. Mental Health, Religion and Culture 2009; 12(2):175-90.
  8. Ahmadizadeh MJ, Ahmadi K, Eskandari H, Falsafinejad MR, Borjali A, Anisi J, et al. Improvement in quality of life after exposure, problem solving and combined therapy in chronic war related war-related post traumatic disorder. Procedia Social and Behavioral Sciences 2010; 5:292-266.
  9. Najafi M, Mohammadi Far MA, Dabiri S, Kamari AA. The comparison of the quality of life in veterans with and without post-traumatic stress disorder. Iranian Journal of War and Public Health 2011; 3(11): 2-35.
  10. Tavalaei SA, Habibi M, Asaari SH, Ghaneei M, Naderi Z, Khateri SH, et al. Quality of life in chemical veterans 15 years after exposure to mustard gas. Journal of Behavioral Sciences 2007; 1(1): 17-25. (Persian)
  11. Aflakseir A, Coleman PG. The influence of religious coping on the mental health of disabled Iranian war veterans. Mental Health, Religion and Culture 2009; 12(2):175-190.
  12. Ebrahimzadeh MH, Fattahi AS. Long term follow up of Iranian veteran lower limb amputees from Iraq-Iran war, a study of 168 case. Kosar Med J 2004; 10:190-220. (Persian)
  13. Hossaini Farhangi S, Dortaj F, Talebi M, Ghaemi F. Satisfaction of veterans from complemented insurance services. Tebjanbaz Journal 2009; 1(4):86-105. (Persian)
  14. Boyle MA, Lahey JN. Health insurance and the labor supply decisions of older workers: Evidence from a US Department of Veterans Affairs expansion. Journal of public economics. 2010; 94(7):467-78.
  15. Bryant RR, Samaranayake VA, Wilhite A. The effect of military service on the subsequent civilian wage of the post-Vietnam veteran. The Quarterly Review of Economics and Finance 1993; 33(1):15-31.
  16. O'toole TP, Conde‐Martel A, Gibbon JL, Hanusa BH, Fine MJ. Health care of homeless veterans. Journal of General Internal Medicine 2003; 18(11):929-33.
  17. Harada ND, Damron-Rodriguez J, Villa VM, Washington DL, Dhanani S, Shon H, Chattopadhyay M, Fishbein H, Lee M, Makinodan T, Andersen R. Veteran identity and race/ethnicity: influences on VA outpatient care utilization. Medical Care 2002; 40(1): 1-117.
  18. Yu XI. The socioeconomic status of young male veterans, 1964-1984. Social Science Quarterly 1992; 73(2):32-41.
  19. Shen Y, Hendricks A, Wang F, Gardner J, Kazis LE. The impact of private insurance coverage on Veterans' use of VA care: insurance and selection effects. Health services research. 2008; 43(1):267-86.