Evidence map›Paper›PMID 33446202›Full record

ReviewInternational journal for equity in health2021

Iran health insurance system in transition: equity concerns and steps to achieve universal health coverage.

Leila Doshmangir, Mohammad Bazyar, Arash Rashidian, Vladimir Sergeevich Gordeev

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in International journal for equity in health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed, 3 pooled it
16.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

63 citing papers in PubMed, 3 syntheses or guidelines pooled it, 92 citations in OpenAlex.

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  12. Navigating policy making in a complex health system landscape: insight from Iran's health ministers.Archives of public health = Archives belges de sante publique · 2025
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3 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 3 countries.

Leila DoshmangirSocial Determinants of Health Research Center, Health Management & Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
Mohammad BazyarDepartment of Public Health, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran. bazyar.mohamad@gmail.com.ORCID 0000-0003-2543-1862
Arash RashidianDepartment of Science, Information and Dissemination, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt.
Vladimir Sergeevich GordeevInstitute of Population Health Sciences, Queen Mary University of London, London, UK.
Medical University of Ilam · IRQueen Mary University of London · GBTabriz University of Medical Sciences · IRWorld Health Organization Regional Office for the Eastern Mediterranean · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEquity, efficiency, sustainability, acceptability to clients and providers, and quality are the cornerstones of universal health coverage (UHC). No country has a single way to achieve efficient UHC. In this study, we documented the Iranian health insurance reforms, focusing on how and why certain policies were introduced and implemented, and which challenges remain to keep a sustainable UHC.

methodsThis retrospective policy analysis used three sources of data: a comprehensive and chronological scoping review of literature, interviews with Iran health insurance policy actors and stakeholders, and a review of published and unpublished official documents and local media. All data were analysed using thematic content analysis.

resultsHealth insurance reforms, especially health transformation plan (HTP) in 2014, helped to progress towards UHC and health equity by expanding population coverage, a benefits package, and enhancing financial protection. However, several challenges can jeopardize sustaining this progress. There is a lack of suitable mechanisms to collect contributions from those without a regular income. The compulsory health insurance coverage law is not implemented in full. A substantial gap between private and public medical tariffs leads to high out-of-pocket health expenditure. Moreover, controlling the total health care expenditures is not the main priority to make keeping UHC more sustainable.

conclusionTo achieve UHC in Iran, the Ministry of Health and Medical Education and health insurance schemes should devise and follow the policies to control health care expenditures. Working mechanisms should be implemented to extend free health insurance coverage for those in need. More studies are needed to evaluate the impact of health insurance reforms in terms of health equity, sustainability, coverage, and access.

Indexed as

Health EquityInsurance, HealthUniversal Health InsuranceHealth ExpendituresHumansIranRetrospective StudiesHealth financingHealth insuranceHealth policy and systems researchIranReform

Identifiers

PMID33446202
PMCPMC7807408
OpenAlexW3126115868

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.