Abstract
Patients‘ satisfaction is one of the five indicators of quality evaluation in healthcare services This study aimed to identify the determinants of dissatisfaction of insurance coverage among patients visited dental healthcare centers from October 2018 to January 2019 in Tehran-Iran. This is a qualitative study. Using deprivation index and taking socio-economic indicators into account, we identified six private and public dental healthcare centers in three districts in the mega city of Tehran- Iran. We conducted 54 in-depth face-to-face interviews with the head of households or their spouses that visited selected dental centers. Data gathering continued until saturation point. Using a hybrid inductive/deductive approach, we used thematic analysis for data analysis. MAXQDA12 software was used to help data management. We extracted 17 subthemes. Fiscal and non-fiscal determinants were identified as two main dissatisfaction determinants of basic and complementary health insurance. High premium and inappropriate benefit package created the greatest dissatisfaction among users of both basic and complementary insurance services. In addition, the interviewees with basic insurance expressed high dissatisfaction with quality of health services, while those with complementary coverage were mostly dissatisfied with insurance reimbursement system Our study indicates to improve patients’ satisfaction with healthcare insurance coverage, policy makers need to consider the affordability of insurance coverage as well as the quality of healthcare services covered by insurers simultaneously.
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