Defining the basic health service package is one of the main challenges of social health insurance organizations. Given the limited financial resources and increasing demand for health services, it is essential to use appropriate methods to prioritize these services. Universal health coverage includes three main dimensions: population covered, health services, and financing of services. On the other hand, common criteria in defining health packages include cost, cost-effectiveness, disease burden, or a combination of them. Income distribution, the vitality or non-vitality of health services, and the financial capacity of insurance organizations are other criteria for defining health packages. In this article, the issue of social health insurance and insurance coverage among selected countries (including Iran) is examined. This article aims to compare the list of health services covered by social insurance and propose a new basic health service package. In a mixed study (quantitative and qualitative), first, types of health services are classified into outpatient and inpatient services. Then, the level of inclusion and coverage of types of health services in selected countries and Iran are analyzed with statistical calculations. The statistical population is all World Bank member countries and the statistical sample is Iran and similar countries in terms of population, GDP, per capita income, and history of social health insurance (totally 16 countries). Part of the data is from the World Bank (2016-2021 period) and the World Health Organization, and the other part is collected through completing questionnaires. The qualitative analysis tool is qualitative content analysis and the use of data coding, and the quantitative analysis tool is descriptive statistics (averages). Based on the results, the proposed package of basic health services includes maternal and new-born health services, child immunization and general vaccination, control of communicable diseases, nutrition, treatment and prevention of non-communicable diseases, mental health, emergency care, food safety, environmental and school hygiene, health education, diagnostic services, essential medicines, medical equipment, and oral and dental hygiene. |