Analyzing the impact of two major factors on medical expenses paid by health insurance organization in Iran

TL;DR

This paper develops a model using two-way ANOVA to analyze how geographical regions and seasons influence healthcare costs paid by Iranian health insurance organizations, aiming to optimize cost allocation and improve insured patient satisfaction.

Contribution

It introduces a novel model for assessing healthcare costs based on regional and seasonal factors, providing insights for better cost management in health insurance.

Findings

Both geographical regions and seasons significantly affect healthcare costs.

Cost allocation based on these factors can reduce overall healthcare expenses.

Adjusting insurance policies seasonally and regionally can increase insured patient satisfaction.

Abstract

In healthcare scope, the profound role of insurance companies is undeniable. Health insurance establishments main responsibility is to support public health financially and promote the quality of health services. Governments subsidies to healthcare insurance, insured payments and insurance companies costs must be specified in such a way that both people and insurers mutually benefit. In this research, we propose a model for determining healthcare costs paid by health insurance organization with regard to two major factors, the geographical regions where the patients live and the seasons when they receive service, using two-way ANOVA method. Since both effects are found to be significant, allocating different insurance costs to the people residing in different regions, and also changing the patterns of insurance extension in different seasons with regard to the results derived from the research, can detract healthcare costs and give more satisfaction to the lower income insured patients.