Recommendations to improve the insurance coverage for physiotherapy services in Iran A multi-criteria decision making approach

Abstract

Background High rate of traffic injuries, climate changes, natural disasters, aging, and chronic diseases have been resulted in a considerable demand for receiving physiotherapy in Iran. However, there are various complications in utilization of physiotherapy services, especially poor insurance coverage. This study investigated and prioritized potential policy recommendations to improve the insurance coverage for physiotherapy services in Iran. Methods The present project was carried out using mix-method (qualitative-quantitative) approach in Iran. In the first phase, a qualitative study was conducted to find the policy recommendations and in the second phase, obtained policy recommendations were prioritized based on the effectiveness, acceptability, cost, fairness, feasibility, and time using Analytical Hierarchy Process (AHP). Results In the first phase, 30 semi-structured interviews with health policy-makers, health insurers, faculty members, rehabilitation experts, and physiotherapists were conducted. Several policy recommendations were proposed by participants. Following the second phase, prioritized recommendations were provided to promote stewardship (e.g. informing the policy-makers about physiotherapy services), collection of funds (e.g. value-added tax on luxury goods and services), pooling of funds (e.g. moving the allocated resources to insurance (third party) mechanism), purchasing (e.g. using strategic purchasing), and benefit package (e.g. considering the preventive interventions) as main components of insurance coverage. Conclusion The findings of this study will be provided a favorable ground to improve the insurance coverage for physiotherapy services in Iran, and decision- and policy-makers can place these recommendations at their agenda settings in the health sector to protect the health status of population, especially disabled groups.

Prioritizing population-based nutrition-related interventions to prevent and control hypertension in Iran: a multi-criteria decision-making approach

“…According to some studies, it is almost impossible to perform completely consistent pairwise comparisons in the AHP method if there are more than nine criteria; this is often overcome by dividing the criteria into sub-criteria [43,44]. AHP has already been applied in various fields, including marketing, research and development project selection and resource allocation, logistics, transportation, and other decision-making contexts [45][46][47][48][49][50]. For instance, Alossta et al solved the optimal location selection problem through the combined AHP method [51].…”

“…The technique was also used in health care and medical decision-making. The usefulness of AHP to support group decisions in the medical and health care domains has been established in several previous studies [ 48 , 52 , 53 ]. The results of a systematic review indicated that AHP is a promising support method for shared decision-making between patients and physicians, evaluation and selection of diagnoses and treatments, development of clinical guidelines, and evaluation and prioritizing of health care policies and technologies [ 54 ].…”