Re-Designing of the Strategies of Basic Services Package on the Scale of Health Insurance in Khuzestan Province

Reforming and revising the basic health insurance package is one of the most propounded issues in health insurance, in other words, the health insurance organization has always been faced with considering the resources limitation- how the re-examining of this package should be done and also on what bases it should be done. Surely, this package will not acquire its ideal quality or administrative capability without determining standards being in fluential in redesign of the package and considering the real role of other different factors and consequently will display its inefficiency technically and financially. This research has been carried out with the aim of explicating the viewpoints suggested by service providers, service receivers and service purchasers, and also, explaining the importance of each index according to these three groups. This research was conducted in 1391 (2011) based on the gauging method of descriptive-exploratory type, indeed. Statistical society subjects were chosen among the health insurance clients, health staff, and health insurance experts, with the approach of accessible society and simplified random sampling; also, analysis of the research were carried out based on received questionnaires. To analyze data, descriptive statistics and the software SPSS-V18 were used. Furthermore, for examining the research goals and comparing them with each other, the mean and for examining the uniformity of priorities (grouping), Freedmen test, were put to use. The results proved that service providers, service receivers and service purchasers believed the most important determining groups in reviewing basic services package at the present and respectively are important influential parameters in consequential interferences in health insurance, influential factors signifying the clients’ satisfaction, influential factors in health services bureau cracy, influential factors in harmonizing dependent and independent health insurance, and influential factors in providing health services. The results of Freedman’s test proved that the abovementioned factors had not been the same and the rule mean of these factors, considering the ranks, differences being signifying displayed that the resources expenditure variable in interferences (with the rank mean of 7.0) is the most significant variable of all and the type and the quality of providing the services (with the rank mean of 2.30) is the least important one. Therefore, for reviewing the insurance package of basic services, it is recommended that because the role of the society in cooperating with insurance organizations in advancing strategic programs is not disregarded and it can influence the policies and the strategies of these organizations, the most important part of the job in this area, would be to analyze the situations and conditions uttered by the three groups mentioned above.

Health Insurance, Basic Services Package, Strategy Re-Design