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      Moving Toward Universal Health Coverage: Four Decades Of Experience From The Iranian Health System

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          Abstract

          Universal health coverage (UHC) during the past decade has become the main goal of the World Health Organization. Access to health services, without suffering financial hardship for the patients, constitutes the key foundation definition of UHC and its three dimensions: population coverage, service coverage, and financial protection. Iranian health policymakers have purposefully or non-purposefully been pursued the UHC goals during the last four decades by the following macro plans: Health corps, establishing and expanding Health-Care Networks, Law of Universal Health and Social Security Insurances, Family Physician, and Health Transformation Plan. In this paper, we evaluated the situation of UHC in the Iranian health system, presented the weaknesses, strengths, and challenges faced with the health system in its implementation, and finally provided some policy recommendations to complete implementation of the policy in the country.

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          Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the Global Burden Disease Study 2010

          Joshua A Salomon, Haidong Wang, Michael Freeman … (2012)
          The Lancet, 380(9859), 2144-2162
          Article 0 comments Cited 308 times – based on 0 reviews     Review now
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            Inequality in household catastrophic health care expenditure in a low-income society of Iran.

            Zahra Kavosi, Arash Rashidian, Abolghasem Pourreza … (2012)
            We assessed change in household catastrophic health care expenditures (CHE) and inequality in facing such expenditures in south-west Tehran. A cluster-sampled survey was conducted in 2003 using the World Health Survey questionnaire. We repeated the survey on the same sample in 2008 (635 and 603 households, respectively). We estimated the proportion of households facing CHE using the 'household's capacity to pay'. We identified the determinants of the household CHE using regression analysis and used the concentration index to measure socio-economic inequality and decompose it into its determinants factors. Findings showed that the proportion of household facing CHE had no significant change in this period (12.6% in 2003 vs 11.8% in 2008). The key determinants of CHE for both years were health care utilization and health care insurance status. Socio-economic status was the main contributor to inequality in CHE, while unequal utilization of dentistry and outpatient services had reduced the inequality in CHE between socio-economic groups. We observed no significant change in the CHE proportion despite policy interventions aimed at reducing such expenditures. Any solution to the problem of CHE should include interventions aimed at the determinants of CHE. It is essential to increase the depth of social insurance coverage by expanding the basic benefit package and reducing co-payments.
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              Political and economic aspects of the transition to universal health coverage.

              William D. Savedoff, David de Ferranti, Amy Smith … (2012)
              Countries have reached universal health coverage by different paths and with varying health systems. Nonetheless, the trajectory toward universal health coverage regularly has three common features. The first is a political process driven by a variety of social forces to create public programmes or regulations that expand access to care, improve equity, and pool financial risks. The second is a growth in incomes and a concomitant rise in health spending, which buys more health services for more people. The third is an increase in the share of health spending that is pooled rather than paid out-of-pocket by households. This pooled share is sometimes mobilised as taxes and channelled through governments that provide or subsidise care--in other cases it is mobilised in the form of contributions to mandatory insurance schemes. The predominance of pooled spending is a necessary condition (but not sufficient) for achieving universal health coverage. This paper describes common patterns in countries that have successfully provided universal access to health care and considers how economic growth, demographics, technology, politics, and health spending have intersected to bring about this major development in public health. Copyright © 2012 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clinicoecon Outcomes Res
                Journal ID (iso-abbrev): Clinicoecon Outcomes Res
                Journal ID (publisher-id): CEOR
                Journal ID (pmc): ceor
                Title: ClinicoEconomics and Outcomes Research: CEOR
                Publisher: Dove
                ISSN (Electronic): 1178-6981
                Publication date (Electronic): 07 November 2019
                Publication date Collection: 2019
                Volume: 11
                Pages: 651-657
                Affiliations
                [1 ]Department of Health Management and Economics, School of Public Health, Urmia University Of Medical Sciences , Urmia, Iran
                Author notes
                Correspondence: Jalal Davoodi Lahijan Department of Health Management and Economics, School of Public Health, Urmia University of Medical Sciences , 11th kilometer of Sero road, West Azarbaijan Province, Urmia5714783734, IranTel +989395928683 Email j.davoodi2020@gmail.com
                Author information
                http://orcid.org/0000-0002-5387-3134
                http://orcid.org/0000-0002-8120-6654
                Article
                Publisher ID: 219802
                DOI: 10.2147/CEOR.S219802
                PMC ID: 6848985
                PubMed ID: 31807038
                SO-VID: 5779469e-373d-4476-83c1-6b13916a2acb
                Copyright © © 2019 Alinia and Davoodi Lahijan.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 17 June 2019
                Date accepted : 09 October 2019
                Page count
                Figures: 2, Tables: 2, References: 61, Pages: 7
                Categories
                Subject: Perspectives

                ScienceOpen disciplines: Economics of health & social care
                Keywords: universal health coverage,health policy,iranian health system,health transformation plan
                Data availability:
                ScienceOpen disciplines: Economics of health & social care
                Keywords: universal health coverage, health policy, iranian health system, health transformation plan

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