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

• Main Authors: Ali Kazemi Karyani, Ali Akbari Sari, Abraha Woldemichael
• Format: Article
• Language: English
• Published: Kerman University of Medical Sciences 2019-08-01
• Series: International Journal of Health Policy and Management
• Subjects: preferences; health insurance; attributes; discrete choice; iran
• Online Access: https://www.ijhpm.com/article_3630_bc0815cff61b56007a61e8e368c77957.pdf

<span class="fontstyle0">Background</span><br /> <span class="fontstyle0">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.<br /></span><br />  <br /> <span class="fontstyle0">Methods</span><br /> <span class="fontstyle0">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.<br /></span><br />  <br /> <span class="fontstyle0">Results</span><br /> <span class="fontstyle0">The final model of this DCE study included 8 attributes, and the findings indicated statistically significant (</span><span class="fontstyle0">P </span><span class="fontstyle0">< .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 (</span><span class="fontstyle0">P </span><span class="fontstyle0">= .485) disutility (OR = 0.95). With the increase in cost coverage level, the probability of choosing health insurance was significantly (</span><span class="fontstyle0">P </span><span class="fontstyle0">< .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 (</span><span class="fontstyle0">P </span><span class="fontstyle0">< .001) disutility (OR = 0.96).<br /></span><br />  <br /> <span class="fontstyle0">Conclusion</span><br /> <span class="fontstyle0">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.</span>