Evaluation of Reasons for Visiting an Adjutant Rural Health Insurance Center in Razavi Khorasan Province by Rural Insured Persons in 2009-2010

Document Type : Research Article

Authors

1 Head of Technical Committee For Evolution of Health System in Razavi Khorasan Province, Mashhad University of Medical Sciences, Mashhad, Iran

2 Mashhad Health Center No. 2, Mashhad University of Medical Sciences, Mashhad, Iran

3 Adjutant Rural Health Insurance Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Adjutant rural health insurance centers (ARHIC) are established with the aim of guiding and serving the rural insured persons in the cities of Iran. The aim of this study was to investigate the reasons for visiting ARHIC of Razavi Khorasan province by rural patients during 2009 and 2010.
Methods: In this descriptive study, demographic features and reasons of villagers who visited Razavi Khorazan province ARHIC in the years 2009 and 2010 were extracted from admission software and were analyzed.
Results: During the 2 years, 69,580 individuals visited the Razavi Khorasan ARHIC which over half of them (54%) were women. The majority of individuals (30826, 44.3%) were those who despite compliance to the referral system and having referral stamp were not admitted by 2nd level of medical care providers and so they had to come for having a second stamp in their insurance booklets. In the next rank, there were individuals (20971, 30.1%) who, against referral system codes, came for receiving referral stamp to be able to be visited by specialists. For 5020 patients (7.2%) admission to hospital became necessary while travelling to the city and so they needed the referral stamp on their insurance booklets. 902 patients (0.3%) come to receive the referral stamp as they thought they needed to be admitted to hospitals, while after further evaluation they were guided to 1st or 2nd level of medical care without needing to be hospitalized. 226 patients (0.3%) primarily needed to only 1st level of medical care.
Conclusion: In order to reduce cases which against referral system codes, are not admitted by 2nd level of medical care providers; raising awareness, educational programs and intra and extra-sectorial cooperation are necessary. To reduce unnecessary visits of villagers to specialists, education and building awareness on how the referral system works and how health insurance booklets should be used is necessary for the insured persons in rural areas.

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