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مشخصات

عنوان:

بررسی میزان تاثیرگذاری اجرای برنامه بیمه سلامت همگانی بر روند کاهش جمعیت فاقد پزشک خانواده شهری (بدون در نظر گرفتن نوع بیمه) و تعیین دلایل عدم ثبت نام بیمه شدگان بیمه سلامت در برنامه پزشک خانواده شهری استان فارس سال 1391 الی 1393



گروه تخصصی:  پزشکی

سازمان مجری:  سازمان بیمه سلامت ایران (طرح های پژوهشی) 

گروه پژوهشی: 

پژوهشگران: 
غربی فاطمه (مسئول طرح)
شیروی مریم (مسئول طرح)

تاریخ خاتمه:  آبان 1394

کارفرما: سازمان بیمه سلامت ایران

خروجی طرح: 
 
تلفن: 

نشانی سازمان مجری: 
 

چکیده:

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کلیدواژگان:

 
 
Title:

The implementation of the public health insurance plan and its effects on decreasing the population who do not have urban family physicians (Regardless of insurance type) and determining why health insured people fail to register to Urban family physician program in Fars province in 2014



Abstract:

Given the fact that human health is a fundamental right for human beings and also a valuable investment for all the countries, the main goal of any health care system is to provide, maintain and improve the population's health. In our country, many programs have been implemented to address this important principle, two of which are currently on the run in Fars province: Urban family physician and public health insurance plan. Urban family physician program in such a vast province as Fars has been carried out with purposes of public and equitable accessibility to the medical services. With regard to the undeniable role of insurance companies in the reformation of health program, public health insurance plan has been implemented since 2014 on the basis of generalizable and compulsory coverage for the public.
In this paper we tried togather interesting outcomes by relating these two governmental primary programs in Fars, as a large province in the country in terms of the number of including cities and health centers, and also geographically. Additionally, It is the first province that is applying this program.
The results of this study demonstrate that the average population without the urban family physician decreased from 1,428,078 people before the implementation of public health insurance plan to 571,140 people after that. By the use of statistical analysis we concluded that applying public health insurance plan has significantly reduced the number of people who do not have urban family physicians.
The target population includes 87,915 people in Fars province in 2014. The Maximum number of non-registration is found in Bavanat and the minimum is in Gerash. As for the design of this study, we defined and calculated two indicators; 1 and 2; for each city in Fars province. Then we investigated the relationship between the ratios of these two indicators to the target population by using statistical tests. We found that the more the Indicator No.2 increases, the proportion of the target population significantly decreases. Furthermore, the target population was assessed in terms of demographic characteristics.
In a telephone survey of 350 randomized subjects of the target population, we explored the reasons for non-registration in the program. Approximately 4% of the subjects reported that they were not aware of the program. They were the residents of the following cities: Izad-khast, Abadeh, Bavanat, Lar, Pasargad and Mamasani in Fars province. The primary reason of failing to register; in spite of the subjects’ reference to the hospitals or private clinics; has been found to be the "transfers of the family physicians".
For the 15% of the subjects, the reason for non-registration has been stated as “saturation of the capacity for a specific physician”. Most of the subjects did not register to the program by giving the reason as "I have not had free time to do it yet".
We also came to the conclusion that advocacy to the family physicians’ referral system has gotten a part of population’s health culture and all of the subjects believed in the competence of this program.



Keyword(s): Program, Target population, Indicator No.1, Indicator No.2