RESUMEN
Background: The gradual movement towards universal health coverage (UHC) is an important issue in many countries. The aim of this study is to identify the role of supplementary health insurance in achieving universal coverage. Methods: This comprehensive review study was conducted to identify the role of supplementary health insurance in achieving universal health coverage. 4894 articles were found in the search in databases (Scopus, PubMed, and Web Science), and finally42 articles were selected. Considering the criteria of titles and abstracts, the reviewed articles were assessed, and a thematic analysis approach was used to analyze the collected data. Results: The review showed 52 Sub dimensions in 7 dimensions. Policymakers can draw on international experiences to ensure that private health insurance contributes to achieving universal health coverage by Providing clarity within the national health financing policy framework regarding the role of private health insurance. Enhancing understanding of how supplementary health insurance impacts the performance of the healthcare system. They are improving oversight of private health insurance, regulating financial protection and consumer support, and implementing thorough market surveillance and proper allocation of health subsidies between the private and public sectors. Conclusion: Supplementary insurance holds promise as a complementary tool in achieving universal health coverage. Addressing gaps in primary insurance and providing additional financial protection can contribute to enhanced access, improved quality of care, and reduced financial barriers to healthcare services. However, careful attention must be given to affordability, equity, regulation, and coordination with primary insurance schemes to ensure its effective implementation and prevent unintended consequences.
RESUMEN
Background: Universal health coverage (UHC) aims to provide access to basic health services with no financial constraints. In Iran, the major challenges to the implementation of the UHC plan include aggregation and augmentation of resources, something which could threaten the dimension of population coverage and health service delivery. Therefore, this study reviews the strengths and weaknesses of the internal environment as well as the opportunities and threats of the external environment in the UHC plan to help policymakers and decision-makers of the health system. Methods: In this review study, reputable databases were searched for all the relevant papers on UHC to collect data. After that, the strengths, weaknesses, opportunities and threats (SWOT) analysis was conducted to organize, collect, and analyze data. The SWOT analysis is a process that has 4 components and 2 dimensions. The 4 components are strengths, weaknesses, opportunities, and threats. In fact, strengths and weaknesses are considered internal factors and organizational features, whereas opportunities and threats are considered external factors and environmental features. The listed items were then categorized for clarification and transparency within the framework of the 6 building blocks of the World Health Organization (WHO). Results: The relevant studies were reviewed to analyze the strengths and weaknesses of internal environments as well as the opportunities and threats of external environments. The necessary points for better planning and policymaking were then presented. Conclusion: The success of Iran's UHC plan can be guaranteed by regular capacity building, ongoing education, and empowerment of society in addition to improving intersectoral collaboration and acquiring political commitment to develop more effective and more accountable systems matching variable and dynamic health requirements.
RESUMEN
Background: Globally, population growth and ageing are expected to increase the risk of vision impairment for more people. Eye disorders impose heavy social and economic burdens on communities through increased poverty, reduced quality of life, and decreased employment. We aimed to calculate the economic burden of eye diseases in Iran. Methods: Prevalence-based and top-down cost estimation methods were used with a sociological approach. Data were collected from the Northeastern Ophthalmology Center Institute for Health Assessment, and Evaluation, besides the 2017 census. Eye diseases were classified according to the ICD10. Data were analyzed using Excel 2016 software. Results: Survey data were collected from 19,113 patients with vision loss and eye disorders. The average cost of vision loss/eye disorders was estimated to be $250.3. The findings indicated that the economic burden of visual diseases was $2,844 million a year, with direct medical costs comprising 87% (66% of inpatient and 21% of outpatient) and direct non-medical and indirect costs estimated at 6% and 7%, respectively. Furthermore, 72.8% of direct medical costs was paid by insurance companies, 20.6% by patients, and 6.6% by the government. Conclusion: Eye diseases and vision loss in Iran, as in other countries, are costly for the health system and society. Instituting effective policies and measures to address this rising burden should be a national priority. Another suggestion in this area would be to focus on preventive care and policies such as health education, highlighting the role of reorientation of health services and advocacy (for policies that promote eye health), where relevant.