Authors
1 Assistant Professor, Health Information Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Associate Professor, Health Information Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 MSc, Education of Medical Records, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
Introduction: Health care is considered as one of the basic needs of human societies. Health insurance is the most appropriate option for all individuals to enjoy equal health care. However,
today, different types of health insurance are facing with various problems which need to be
solved through new laws. Therefore, Health Insurance Portability and Accountability Act
(HIPAA) was approved to solve problems in the US health insurance system. We decided to
study HIPAA and the possibility of its implementation in Iran in order to solve the problems of
Iranian health insurance system.
Methods: In this descriptive exploratory research, data was collected by reviewing reliable
sources and referring to health insurance organizations and universities of medical sciences in
Tehran, Iran during 2009. Using a questionnaire, 24 academic and health insurance management
experts were asked about the possibility of applying HIPAA in Iran. The validity and reliability
of the questionnaire were determined by content validity and test-retest method (r = 0.84).
Results: Based on our results, increased health care costs, lack of continuous health insurance
coverage and too much bureaucracy were the most important problems of the American health
insurance system. In addition, 66.66% of the studied health insurance experts identified increased
costs as the first factor in the reform in the Iranian health care system. A total of 83.33% of the
experts agreed with the health insurance system reform in Iran.
Conclusion: HIPAA includes important approaches to solve the problems in the American health
insurance. Considering the similarity of the problems in American and Iranian health insurance
systems, experts agreed with the need for electronic data interchange, creating a national identification in the health care industry, and implementation of a comprehensive information system to
coordinate the insurance system.
Keywords