Volume 8, Issue 1 (Jan-Mar 2019)                   JCHR 2019, 8(1): 18-28 | Back to browse issues page


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Pakdaman M, Shafiei M, Geravandi S, Hejazi A, Abdi F. The Interaction between Insurance Organizations and Health System: The Insurance Mechanism based on Game Theory. JCHR. 2019; 8 (1) :18-28
URL: http://jhr.ssu.ac.ir/article-1-509-en.html
1- Health Policy and Management Research Center, Department of Health Care Management, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd , Iran
2- Department of Health Services Management, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd , Iran
3- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
4- Department of Community Medicine , Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
5- Department of Health Services Management, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd , Iran , farhadtl@hotmail.com
Abstract:   (474 Views)
Introduction: In order to achieve the highest level of effective interaction between the insurance organizations and the health system, efforts should be made to identify existing communication challenges for policymakers and decision makers. The present study was conducted to identify interactive behaviors aimed at designing an insurance mechanism based on game theory to cover the existing gaps.
Methods: This study consisted of two phases of qualitative and quantitative. In the qualitative phase, data were collected and classified by a semi-structured interview with a number of insurance professionals in insurance organizations and the health system. In the quantitative phase of the study, interactive behaviors between the two organizations were studied. Finally, with the help of Gambit software, the insurance mechanism was designed.
Results: In the qualitative phase, the data were collected in three main categories: behavioral and communicative, structural and financial and deductibles and 11 sub-categories. In the quantitative phase, 35 optimal interactive behavioral strategies were delineated.
Conclusion: The best behavioral strategy for interaction between insurance organizations and health system, to fill gaps in insurance system and to improve the interaction between the two organizations, was introduced in the form of 35 strategies to provide an insurance mechanism.
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Review: Research | Subject: Public Health
Received: 2019/03/9 | Accepted: 2019/03/9 | Published: 2019/03/9

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