Health insurance literacy for the Iranian community, a qualitative study: brief report

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 semi-structured 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 organization'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 re-examined and confirmed Results: By reviewing the collected texts, 264 initial codes, 21 components, 10 sub-themes, 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 self-confidence, the theme of self-efficacy (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 decision-making behavior and seeking insured treatment in the health market.