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5 7/ 393 AP-.(3)..... Maghsoodi S, Hesabi M, Monfared A. General health and related factors in employed nurses in Medical-Educational Centers in Rasht. Holistic Nursing and Midwifery Journal. 05; 5: Mehrolhassani M, Yazdi Feizabadi V, Mohammadi M, Abolghasem Gorgi H. Fuzzy approach for strategic plan assessment: A case study at Kerman healthcare insurance. Journal of Health Administration. 00; 3: Arab M, kavoosi z, Ravangard R, Ostovar R. Health insurance system. Tehran: Academic center of Education culture and Research-Tehran branch:00. Wagstaff A, Lindelow M. Can insurance increase financial risk? : The curious case of health insurance in China. Journal of health economics. 008; 7: The fifth Economic development, social and cultural plan of Islamic Republic of Iran. 00. Available at: 6. ahvvole.edari/ghavanin/ghanune-barname-panjom.pdf. 7. Khajavi Sh, Sayrani M, Allahyari A. The Feasibility of Balanced Scorecard Implementation in Performance Measurement of Shiraz Hospitals. Empirical Studies in Financial Accounting. Spring 0; 8: Najafi E, Aryanezhad M. A BSC- approach to measure the relative efficiency of service industry: A case study of banking sector. International Journal of Industrial Engineering Computations. 0; : Roodposhti FR, Lotfi FH, Ghasemi MV. Performance evaluation through data envelopment analysis technique and balanced scorecards approach and its application in bank. Applied Mathematical Sciences. 00; : Wang Y, Li Y, Jan C, Chang K. Evaluating firm performance with balanced scorecard and data envelopment analysis. WSEAS Trans Bus Econ. 03; 0: Saber-Mahani A, Goodarzi G, Barouni M, Khakian M. 80 %8. % %0 80 %80.(3) %3 88 %8 80 %7.(0) 80.() %53 %6 %. 88 Estimation of technical efficiency of general hospitals of Kerman University of Medical sciences by data envelopment analysis () method IN 007. Journal of Kerman University of Medical Sciences. 00; 7: Askari R, Goudarzi R, Fallahzadeh H, Zarei B, Dehqani Tafti A. Efficiency appraisal of Yazd university of medical science hospitals by quantitative approach data envelopment analysis (). Journal of Payavard Salamat. 0; 6: Momeni M, Khodaee S, Bashiri M. Performance Assessment of Social Security Organization by Combinating F and BSC Models. Journal of Industrial Management. 009; : Nasiripour A, Mehrolhasani M. The Efficiency of the Head Offices of Medical-Services Insurance Organization in Iran Using AP-: 009. Journal of Health Administration. 0; : Tone K, Sahoo BK. Evaluating cost efficiency and returns to scale in the Life Insurance Corporation of India using data envelopment analysis. Socio-Economic Planning Sciences. 005; 39: Kao C, Hwang S-N. Efficiency decomposition in two-stage data envelopment analysis: An application to non-life insurance companies in Taiwan. European Journal of Operational Research. 008; 85: Cummins JD, Weiss MA, Xie X, Zi H. Economies of scope in financial services: A efficiency analysis of the US insurance industry. Journal of Banking & Finance. 00; 3: Eling M, Luhnen M. Efficiency in the international insurance industry: A cross-country comparison. Journal of Banking & Finance. 00; 3: Wu D, Yang Z, Vela S, Liang L. Simultaneous analysis of production and investment performance of Canadian life

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7 Iranian Journal of Epidemiology 07; (5), Special Issue (Efficiency and financial protection in the Health system of Iran): 3-9. Original Article Assessment of the Performance of Health Insurance Organizations using the Approach; 0 Ghasemi E, Barooni M, Dehnavieh R 3, Jafari Sirizi M, Mehrolhassani MH 5 - MSc Student in Health Services Management, Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran - Assistant Professor in Health Economics, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran 3- Associate Professor in Health Services Management, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran - PhD in Strategic Management, Kerman Health Insurance organization, Kerman, Iran 5- Associate Professor in Health Services Management, Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Corresponding author: Mehrolhasani MH, mhmhealth@kmu.ac.ir Background and Objectives: Health insurance would guarantee people security against disease and health problems. Given the key role of health insurance in achieving the goals of justice and reducing the out-of-pocket payment, this study aimed to evaluate the performance of Iran health insurance using the model in 0. Methods: This was a cross sectional study. The study population included all Iran health insurance organizations. input and output criteria were selected by targeted library and documentary review and the data were collected accordingly. The determinants of efficiency were evaluated using liner regression. Results: The mean technical, management, and scale efficiency of Iran health insurance head offices was 0.593, 0.76, and 0.7, respectively. Considering the findings, the capacity of efficiency promotion at these head offices was approximately %. Regarding technical efficiency, 5 head offices had the maximum efficiency (), 7 head offices had efficiency between 0.5 and, and 9 head offices had efficiency less than 0.5. In addition, the variables of population and total number of institutions had a significant impact on efficiency. Conclusion: Based on defined variables, input oriented AP- model was appropriate. The results showed a great capacity for increasing technical efficiency in the Iranian health insurance organizations which could be increased by benchmarking efficient and reference organizations and also adjusting their input. For this purpose, downsizing and agility of the Iranian health insurance organizations based on the e-government clause are proposed for administrative system reform. Keywords: Performance assessment, Efficiency, Data envelopment analysis, Health insurance