Document Type: Original Article
Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
student research committee, Shiraz University of Medical Sciences, Shiraz, Iran
Ph.D. candidate of health services management, Student Research Committee, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.
Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Ira
Introduction: One of the most reliable sources of financing healthcare costs is health
insurance. Covering all the services by basic health insurance is not affordable economically, so that some services are covered by supplementary health insurances. This study aimed to determine the factors influencing buying the different levels of Kowsar supplementary health insurance by the staff of Shiraz University of Medical Sciences in 2014-2015.
Methods: This is a cross-sectional study. Two data collection forms were used to collect the
data. A sample size of 500 was determined using the rule of thumb. The individuals were
selected via using two-stage stratified and systematic sampling. To do the estimation, the
ordinal logistic regression model (link function was logit) was specified by the one-sided
significant variable tests at the first step. Then, the independent variables were examined by the link test, and the linear relationship among variables was also investigated. The software Excel 2010 and STATA 11.0 (stata corp LLC) were used in this paper.
Results: The findings showed that among the people with supplementary insurance, the
majority were males (60%), married (85%), with the basic Tamin Ejtemaei insurance (72.3%). Among those who have not chosen the supplementary health insurance, the largest number were women (69%), unmarried (53%), and insured by Tamin Ejtemaei (80%), respectively. The findings suggest that some factors such as the age, gender, income and cost of insurance packages are the most influential factors on buying different levels of health care insurance. In the first model that included people with supplementary insurance, the income elasticity was significant and positive (Beta=3, P=0.047) and price elasticity of demand was negative (Beta=-0.06, P=0.001). In the second model that complemented those with and without supplementary insurance, the income elasticity was insignificant (Beta=2.46, P=0.085), and the demand price elasticity was negative (Beta=-0.06, P=0.001).
Conclusion: The economic factor seems to be the most influential factor in choosing
supplementary insurance. Since this problem causes the low-income households not to use
the insurance; therefore, the government is required to allocate some subsidies for low income household to be covered by supplementary health insurance for special services.