مطالعه تطبیقی سیاست‌ها و استراتژی‌های معاونت درمان سازمان تأمین اجتماعی ایران و کشورهای منتخب
محورهای موضوعی : -مدیریت خدمات بهداشتی و درمانی
منصوره دینی
1
,
سید جمال‌الدین طبیبی
2
,
لیلا ریاحی
3
,
کامران حاجی نبی
4
1 - دانشجوی دکتری مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
2 - استاد، گروه مدیریت خدمات بهداشتی و درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
3 - دانشیار،گروه مدیریت خدمات بهداشتی و درمانی،واحد علوم و تحقیقات،دانشگاه آزاد اسلامی،تهران، ایران
4 - استادیار،گروه مدیریت خدمات بهداشتی و درمانی،واحد علوم و تحقیقات،دانشگاه آزاد اسلامی،تهران
کلید واژه: تامین اجتماعی , سیاست , استراتژی , مطالعه تطبیقی,
چکیده مقاله :
مقدمه: هدف از مطالعه حاضر، بررسی تطبیقی سیاست‌ها و استراتژی‌های معاونت درمان سازمان تأمین اجتماعی به‌عنوان دومین سازمان ارائه‌دهنده بیمه‌های اجتماعی و درمان ایران با 5 کشور دیگر است. روش پژوهش: این پژوهش یک مطالعه تطبیقی با رویکرد کیفی است که در سال 1401 انجام شد، نمونه‌گیری به‌صورت هدفمند بوده و پنج کشور ژاپن، کاستاریکا، مصر، یونان و مکزیک در مؤلفه‌های سیاست‌ها و استراتژی‌ها شامل تولیت و مدیریت درمان، مؤلفه‌های اجتماعی، تأمین مالی و بیمه ائی، قانونی، سیاست‌گذاری و برنامه استراتژیک با ایران مقایسه شدند. در این مطالعه از پایگاه اطلاعاتی معتبر استفاده و داده‌ها با استفاده از مدل آموزش تطبیقی در چهار مرحله توصیف، تفسیر، هم‌جواری و مقایسه تجزیه‌وتحلیل و در قالب جدول تطبیقی مقایسه شدند. یافته‌ها: نتایج حاکی از تأثیر مؤلفه‌های تولیت و مدیریت بهداشت و درمان، تأمین مالی و بیمه ائی، اجتماعی، قانونی، سیاست‌گذاری و برنامه استراتژیک بر سیاست‌ها و راهبردهای معاونت درمان سازمان تأمین اجتماعی است؛ که مؤلفه اجتماعی با میانگین 8/92 % بیشترین فراوانی مشاهده شده در میان اسناد مورد قبول و مؤلفه برنامه استراتژیک با میانگین 5/65% کمترین درصد فراوانی مشاهده شده در میان اسناد مورد قبول را دارا بود. نتیجه‌گیری: توجه به جمعیت سالمندی رو به رشد، توجه به پایداری مالی سازمان تأمین اجتماعی، اجرای صحیح قوانین و سیاست‌گذاری‌های بیمه ائی و درمانی و تدوین صحیح و علمی برنامه استراتژیک می‌تواند به بهبود ارائه خدمات درمانی و بهبود در مدیریت مصارف و منابع سازمان منجر شود؛ بنابراین ضروری است که بازنگری و اصلاح در سیاست‌ها و استراتژی‌های معاونت درمان تأمین اجتماعی صورت گیرد.
Introduction: The purpose of this study is to compare the policies and strategies of the Social Security Organization as the second provider of social insurance and treatment in Iran with 5 other countries. Methodos: This research is a comparative study with a qualitative approach that was conducted in 1401, the sampling was purposeful and the five countries of Japan, Costa Rica, Egypt, Greece and Mexico in the components of policies and strategies, including treatment management and administration, social components, provision Financial and insurance, legal, policy making and strategic plan were compared with Iran. In this study, an authentic database was used and the data were analyzed using the comparative education model in the four stages of description, interpretation, juxtaposition and comparison, and compared in the form of a comparative table. Results: The results indicate the impact of the components of health and treatment management, financing and insurance, social, legal, policy making and strategic plan on the policies and strategies of the treatment deputy of the Social Security Organization; The social component with an average of 92.8% had the highest frequency observed among the accepted documents and the strategic plan component had the lowest frequency observed among the accepted documents with an average of 65.5%. Conclusion: Paying attention to the growing elderly population, paying attention to the financial stability of the social security organization, the correct implementation of the insurance and medical policies and the correct and scientific formulation of the strategic plan can lead to an improvement in the provision of medical services and an improvement in the management of expenses and resources of the organization. ; Therefore, it is necessary to review and modify the policies and strategies of the deputy of social security treatment.
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