سواد بیمه سلامت برای جامعه ایرانی، یک مطالعه کیفی: گزارش کوتاه

زمینه و هدف: سواد بیمه سلامت مفهوم نوپایی است که به‌طور عمده پس از اجرای قانون موسوم به اوباماکر (obamacare) در ایالات متحده پا به عرصه وجود نهاده است. این مطالعه به‌دنبال شناسایی ابعاد سواد بیمه سلامت در جامعه ایرانی است.روش بررسی: در این مطالعه کیفی داده‌ها با استفاده از 9 مصاحبه نیمه‌ساختار‌یافته، 10 نشست گروه‌ کانونی با حضور 86 نفر از کارشناسان یک سازمان بیمه‌گر و یک نشست تخصصی با حضور 15 نفر از خبرگان ‌دانشگاهی، از شهریور تا آذر 1397 و در محل این سازمان، گرد‌آوری و به شیوه تحلیل محتوای کیفی جهت‌دار بر پایه مدل مفهومی مورد بررسی قرار گرفت. یافته‌ها: داده‌ها در سه محور سازماندهی شدند. در محور دانش، ابعاد شناخت بیمه‌سلامت و آگاهی از حقوق و تکالیف بیمه‌شده، در محور مهارت، ابعاد جستجوی اطلاعات و خدمات و بهره‌برداری از پوشش بیمه‌ای، و در محور اعتماد‌به‌نفس، خودکارآمدی شناسایی شده‌اند.نتیجه‌گیری: سواد بیمه سلامت برای جامعه ایرانی به جای توانایی در انتخاب نوع بیمه، بر کاربرد آن در بهبود رفتار تصمیم‌گیری و جستجوی درمان بیمه شده در بازار سلامت متمرکز است.

Prediction of the Iranians self-care in terms of communication pattern of their individual and social characteristics in face of Covid-19 pandemic-2020

Background: Health insurance literacy is a nascent concept that has emerged mainly after the implementation of the law known as Obamacare in the United States. This study seeks to identify the themes of health insurance literacy in Iranian society.Methods: The study approach is qualitative. Data were collected using nine semistructured interviews, ten focal group meetings with the presence of 86 experts of an insurance organization and a specialized meeting with fifteen academic experts, from September to December 2018 at the organizationchr('39')s location. MAX QDA10 software was used to organize the data. Qualitative data analysis was performed using continuous comparison analysis and in the form of directional qualitative content analysis based on the conceptual model (Paez et al 2014). Coding was performed independently by two researchers and then collected. Results were reviewed by an external observer. Finally, in a specialized meeting with the participation of representatives of specialized (groups secretaries) and academic experts(participants in the initial interviews), the findings of the study were reexamined and confirmedResults: By reviewing the collected texts, 264 initial codes, 21 components, 10 subthemes, and five themes were extracted. Based on the conceptual model of the study, the data were organized in three axes. In the knowledge axis, the themes of health insurance knowledge (including health insurance knowledge and attitude toward health insurance) and awareness of insured rights and assignments (including insured assignments and insured rights), in the axis of skill, themes of information search and services (including information acquisition and service search) and utilization of insurance coverage (including receiving insurance coverage and benefiting from benefits), and in the axis of selfconfidence, the theme of selfefficacy (including Timely decision making and environmental awareness) have been identified.Conclusion: Health insurance literacy for Iranian society, instead of being able to choose the type of insurance, focuses on its application in improving decisionmaking behavior and seeking insured treatment in the health market.