International Journal of Health Policy and Management

International Journal of Health Policy and Management

Eliciting Preferences for Health Insurance in Iran Using Discrete Choice Experiment Analysis

Document Type : Original Article

Authors
Ali Kazemi Karyani 1, 2
Ali Akbari Sari 2
Abraha Woldemichael 3, 2
1 Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
2 Department of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
3 School of Public Health, College of Health Sciences, Mekelle University, Tigray, Ethiopia
10.15171/ijhpm.2019.29
Abstract
Background
The preferences of Iranians concerning the attributes of health insurance benefit packages are not well studied. This study aimed to elicit health insurance preferences among insured people in Iran during 2016.

 
Methods
A mixed methods study using a discrete choice experiment (DCE) approach was conducted to elicit health insurance preferences on a total sample of 600 insured Iranians residing in Tehran. The final design of the DCE included 8 health insurance attributes. Data were analyzed using conditional logistic regression models.

 
Results
The final model of this DCE study included 8 attributes, and the findings indicated statistically significant (P < .001) increase in the odds ratio (OR) of choosing health insurance at all levels of cost coverage except for the rehabilitation and para-clinical benefits, where at 70% cost coverage there was insignificant (P = .485) disutility (OR = 0.95). With the increase in cost coverage level, the probability of choosing health insurance was significantly (P < .001) the highest for the private hospitals’ benefits (OR = 2.82) followed by public hospitals’ benefits (OR = 2.02) and outpatient benefits (OR = 1.75), and the premium revealed statistically significant (P < .001) disutility (OR = 0.96).

 
Conclusion
Our findings revealed that participants would be willing to choose health insurance plans with higher cost coverage of healthcare services and with lower premiums. However, the demographic characteristics, income, and health status of the insured individuals affected their health insurance preferences. The findings can contribute to the design of better health insurance policies, improve the participation of individuals in health insurance, and increase the insured individuals’ utility from the insurance benefits packages.
Keywords
Preferences
Health Insurance
Attributes
Discrete Choice
Iran
Subjects
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International Journal of Health Policy and Management
Volume 8, Issue 8
August 2019
Pages 488-497

  • Received Date 03 July 2018
  • Revised Date 21 April 2019
  • Accepted Date 08 May 2019
  • First Published Date 01 August 2019
  • Published Date 01 August 2019