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LETTER TO EDITOR
J Res Med Sci 2018,  23:74

Unmet health-care needs in people with disabilities: An evidence to make reforms in health insurance programs in Iran


Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah; Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Date of Web Publication23-Aug-2018

Correspondence Address:
Dr. Shahin Soltani
Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah; Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrms.JRMS_276_18

Clinical trial registration IRCT2017020732444N1

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How to cite this article:
Soltani S. Unmet health-care needs in people with disabilities: An evidence to make reforms in health insurance programs in Iran. J Res Med Sci 2018;23:74

How to cite this URL:
Soltani S. Unmet health-care needs in people with disabilities: An evidence to make reforms in health insurance programs in Iran. J Res Med Sci [serial online] 2018 [cited 2018 Dec 19];23:74. Available from: http://www.jmsjournal.net/text.asp?2018/23/1/74/239574



Sir,

In Iran, people with disabilities (PWDs) consist of 1.3% of general population, but the World Health Organization's report cites that around 15.6% of world population experience type of disabilities.[1],[2] Studies show that PWDs are more likely to report poorer health than their counterparts without a disability. Although disability is not a disease, it can cause more health problems among PWD than the general population. On the other hand, these people encounter with cascades of disparities and barriers to access to health-care services including cultural, physical, and financial barriers.[3]

Since PWDs are more likely to experience poverty than the general population, they need more financial protection to use health services than others. However, some studies in Iran indicate that PWD to promote their health need services that is not covered by health insurances. These services frequently are used by PWD, but there is no insurance coverage for them, and thus PWDs have to pay out of pocket. These services such as dental care services, rehabilitation services, and assistive devices usually cost a lot, and PWD cannot afford to use these type of services.[4],[5],[6]

This problem highlights that health needs of vulnerable groups are not fulfilled by the public health insurances completely, and there is a need to revise current benefit packages and develop a health insurance fund to cover health needs of PWD effectively. For example, Medicaid programs in the United States provide mandatory and optional benefits for PWD.[7] Thus, it sounds that special health needs of PWD cannot be covered by common health insurances and policymakers should consider some effective policy options to reduce disparities in health insurances coverage. In this article, we have proposed the suggestions to develop special benefit packages for PWD in Iran. These suggestions need to be supported by different stockholders including policymakers, Nongovernmental Organizations, and PWD.

  • Making law reforms:First, we need to investigate existing laws to assure the right of PWD to receive acceptable and affordable health-care services
  • Developing a special benefit package: PWDs have various and special health-care needs that are not covered by the current benefit packages. Thus, there is a need to design new packages according to socioeconomic and health status of PWD
  • Equitable Health system financing: Equitable financing for universal coverage should ensure that financial obstacles do not prevent vulnerable groups from access to health-care services they need. Of these, government and health insurances should play main roles to financial risk protection of PWD
  • Creating social-political movements: The history of disability in developed countries show that social movements have important influences on the society attitudes and policy processes
  • Conducting health economics researches: Basically, designing a special benefit package needs to conduct extensive economics studies such as cost-effectiveness and cost-utility studies.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Soltani S, Hafshejani AM, Salehiniya H. Trend of disability prevalence in Iran: An evidence to improve disability data. J Res Med Sci 2015;20:531-2.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
World Health Organization. World Bank (2011) World Report on Disability. Malta: World Health Organization; 2012.  Back to cited text no. 2
    
3.
Naaldenberg J, Kuijken N, van Dooren K, van Schrojenstein Lantman de Valk H. Topics, methods and challenges in health promotion for people with intellectual disabilities: A structured review of literature. Res Dev Disabil 2013;34:4534-45.  Back to cited text no. 3
    
4.
Soltani S, Takian A, Akbari Sari A, Majdzadeh R, Kamali M. Cultural barriers in access to healthcare services for people with disability in Iran: A qualitative study. Med J Islam Repub Iran 2017;31:51.  Back to cited text no. 4
    
5.
Abdi K, Arab M, Rashidian A, Kamali M, Khankeh HR, Farahani FK, et al. Exploring barriers of the health system to rehabilitation services for people with disabilities in Iran: A qualitative study. Electron Physician 2015;7:1476-85.  Back to cited text no. 5
    
6.
Sharifi A, Kamali M, Chabok A. Rehabilitation needs of people with cerebral palsy: A qualitative study. Med J Islam Repub Iran 2014;28:16.  Back to cited text no. 6
    
7.
Keohane LM, Rahman M, Mor V. Reforming access: Trends in medicaid enrollment for new medicare beneficiaries, 2008-2011. Health Serv Res 2016;51:550-69.  Back to cited text no. 7
    




 

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