Keyvanara M¹ (PhD), Jabbari AR² (PhD), Rahi F²* (MD), Azizzadeh M² (MD)

¹ Social Determinants of Health Research Center, School of Management and Medical Information,

Isfahan University of Medical Sciences, Isfahan, Iran.

² Department of Health Management, School of Management and Medical Information,

Isfahan University of Medical Sciences, Isfahan, Iran

Original Article

Received: 3 Nov 2015, Accepted: 24 Feb 2016

Abstract

Introduction: Setting tariffs is one of the most important tools of policy makers at Health system in every country for applying stewardship which is effective on justice, effectiveness, quality and accountability of health services, and also could influence the accessibility and the rate of using health care services. The changing of medical tariffs not only could affect the income of medical and hospital service providers, but also  could affect the costs of the funders of medical and hospital services. This study was conducted to investigate the concept of real tariff from insurance organizations managers’ point of view.

Methods: This qualitative study was conducted using in-depth interview with 19 informed managers, or relevant managers of insurance organizations, social security and armed forces. Data was analysed thematic analysis method.

Results: In general four main challenges were reported by participants as the challenges of tariffs including: methods, structure and principles of tariff setting; economic aspects, dissatisfaction of professionals involved with tariff setting, and lack of supervision on non-tariff expressed, and implementation challenges.

Conclusion: The identified challenges should be taken into account to modify the tariff setting, and to identify problems. The practical principles should be considered to determine tariffs as well as the scientific and logical principles.

Key words:Tariff, Medical tariff, Managers, Challenges

Please cite this article as follows:

Keyvanara M, Jabbari AR, Rahi F, Azizzadeh M. The challenges of the tariffs in medical services of health care system from the perspective of the managers of insurance agencies: A qualitative study. Hakim Health Sys Res 2016; 19(1): 13- 24.