Objective(s): To assess challenges of determining basic health insurance package in Iran. Methods: We interviewed a purposeful sample of 20 participants from 7 main stakeholders in Iranian health insurance system in 2009. We asked about main challenges of determining basic health insurance package in Iran and used the framework method for the analysis.Results: Agreement on General Principle, determining Criteria to define Basic Health Insurance Package, Organization, Financing, Payment System, Regulations, Benefits range, Composition and manner of population coverage, Coordination, Behavior, Policy Making, Surveillance and Control had been introduced as main Challenges of Determining Basic Health Insurance Package in Iran.Conclusion: Determining an appropriate health insurance package in Iran needs a systematic view and a long term plan. The plan should aim to respond to the above concerns.

Introduction: Neglecting to define important criteria in developing a Basic Health Insurance Package and to notice their real roles will result in defining a package which is politically unacceptable, non-economical, technically inefficient or mixed of them. Therefore development of Basic Health Insurance Package should be according to appropriate composition of influential criteria. This study was carried out to determining Information Criteria to define Basic Health Insurance Package and their importance.Methods: The study was qualitative, descriptive, and cross-sectional, conducted in 2008. At the first Stage 20 Health insurance experts and involved people were interviewed. At the second stage the notified criteria in these interviews in addition to other criteria, revealed from conceptual study were viewed by experts of Iranian basic health insurance companies (52 People). The first stage data were analyzed in Atlas-Ti and the second stage data were analyzed in SPSS.Results: The revealed criteria from the first stage were classified as 32 criteria in Six groups. Iranian health insurance experts believed that most important factors involved in defining Iranian basic health insurance package were applicability, the view of politic individuals and groups, interventions cost, and patients’ membership in vulnerable patient groups. The study participants indicated cost-effectiveness of services, effectiveness of services, quality of evidence, and equity as the main factors by which the basic health insurance package can be defined appropriately. Conclusion: According to results the current influence of some criteria such as the view of politic individuals and groups, and vulnerable patient groups were much more than their appropriate influence in defining Iranian basic health insurance package. Also some criteria like cost- effectiveness, quality of evidence, long-term sustainability, and safety of manipulations were focused less than what was appropriate for defining the package. According to the results of this study it is suggested that for defining basic health insurance package more appropriately, Cost-effectiveness studies should be facilitated and the results of such studies should replace such criteria like the influence of different groups in defining basic health insurance package.

Background and Aim: Using a proper method to prioritize and develop a basic health services package is a serious challenge. This study was conducted to design a process for developing and revising a basic health services package in Iran. Materials and Methods: A combined study of quantitative and qualitative methods was used in this study. The qualitative part was conducted through holding 25 in-depth individual interviews and two focus group discussions with experts from the Ministry of Health and Medical Education, Program and Budget Organization and insurance organizations, while the quantitative part was a descriptive cross-sectional study including 277 experts using a valid and reliable questionnaire. Data analysis of the qualitative and quantitative parts was done using a content analysis and the SPSS-23 software, respectively. Results: The process of developing a basic health services package includes 4 steps, namely, explaining the list of services in the basic health services package, extracting the criteria for including services in the service package, prioritizing the criteria for including services in the package, and comparing services with priority criteria. In the prioritization stage, disease burden criteria, target groups and community needs were found to have the highest means and recognized as the most important criteria. Conclusion: The process designed in this study for developing and revising a basic health services package provides policymakers with the required scientific evidence by emphasizing the introduction and continuity of services that have higher priorities and the elimination of services that have lower priorities.

Dear Editor-in-Chief All health systems are facing a paradox of limited resources against the unlimited human needs. Therefore, any country in the world is not able to meet all the health needs of the population and provide all services. The available resource alloca-tion in the best way possible is essential (1, 2).

Objective (s): The Iranian population is rapidly aging, and a large volume of services are provided in comprehensive health service centers with the aim of reducing the costs and care burden of the elderly population, therefore, identifying the factors affecting the elderly's not visiting the health service centers is of great importance. This study was conducted to determine and compare the reasons for the elderly's not visiting the comprehensive health service centers from the perspective of elderly residents of Esfarayen. Methods: This investigation is a cross-sectional descriptive-analytical study. Its statistical population was all elderly residents of Esfarayen city. Initially, 290 elderly people who had not visited comprehensive health centers in the past two years were reviewed by census method. Then, they responded to demographic questionnaires concerning the reasons for the elderly’s not visiting comprehensive health centers, which were psychometrically tested by Masumi et al. (2022). The collected data were analyzed using descriptive and analytical statistical tests, including mean, standard deviation, frequency, Spearman, Mann-Whitney, and Kruskal-Wallis in the SPSS-27 statistical software. The significance level in all tests was considered to be 0. 05. Results: In this study, 245 elderly people (59. 6% female, 40. 4% male) with a mean age of 72. 25±9. 37 years participated. According to the results, the most common reason for the elderly participants not to visit comprehensive health service centers was the inadequate physical conditions of comprehensive health service centers, and the least common reason was insufficient awareness and knowledge about the provision of health and medical services. Conclusion: To improve health services and increase older people's access to healthcare, service providers must pay close attention to existing barriers and seek comprehensive and effective solutions to address them. In this regard, paying attention to the opinions and needs of older people and their participation in the process of designing and implementing health services can lead to continuous and sustainable improvements in their access to health care.

Background and Aim: Cancer patients face many challenges. They are trying to use spiritual approaches to adapt to these challenges. This study aimed to investigate the effectiveness of a spiritual health promotion package based on the basic beliefs of kidney cancer patients in Tehran. Methods: The research method was semi-experimental with a pre-test, post-test, and follow-up design with a control group. The statistical population was all people with kidney cancer who were members of the Tehran Kidney Cancer Society in 2022-2023, and 30 people were selected in a targeted way and randomly assigned to the experimental group and the control group. The health promotion package based on spiritual prosperity was implemented in the experimental group. Catlin and Epstein's (1992) Basic Beliefs Questionnaire was used to collect information. Data were analyzed using SPSS 22 software and variance analysis or repeated measurement. Results: The results indicate that the mean scores of the patients' basic beliefs between the experimental and control groups have a significant difference (P<0.001) and the spiritual health promotion package based on prosperity increases the patients' basic beliefs in patients with kidney cancer in a stable manner (P<0.001). Conclusion: According to the results, the spiritual health promotion package can be effective in improving the basic beliefs of kidney cancer patients.