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 o...

Data resource basics: The National Health Information Database (NHID) is a public database on health care utilization, health screening, socio-demographic variables, and mortality for the whole population of South Korea, formed by the National Health Insurance Service. The population included in the data is over 50 million, and the participation rate in the health screening programs was 74.8% i...

the purpose of this paper is to empirically investigate the factors affecting demand for medical care in iran the population for this study relates to the medical care insurance organization of iran. for the sake of conducting the analysis a sample of 4260 individuals are chosen using a fuzzy sampling procedure. the data was then analyzed using a multinomial logit model. the results show that p...

The term medical necessity has been mainly a placeholder in insurance plans for over thirty years. More recently, the national health care reform debate and litigation over denials of costly experimental treatments have broken the term out into open discussion about what a necessary service is and who should decide if it is covered. This paper summarizes the history of the term and its evolutio...

Poor health status, rapidly escalating health care costs, and seemingly little association between investments in health care and health outcomes have prompted a call for a "pay-for-performance" system to improve population health. We suggest that both health plans and clinical service providers measure and report the rates of 5 behaviors: 1) smoking, 2) physical activity, 3) excessive drinking...

Since 1948 the private sector has viewed itself as complementary to the NHS. Before the NHS was set up in 1948 health care was provided by charities and voluntary hospitals, private medical clubs, occupational medical services and works clubs, fee for service insurance, friendly societies, public medical services (which were funded by subscription), and medical fees paid on an ad hoc basis. The...