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Normal aging changes, acute and chronic illness, and the long stay in the hospital made the decline in elderly physical and mental abilities in non-instrumental and Instrumental Activities Daily Livings (IADL). This paper aims to determine the validity and reliability of Lawton IADL in the Iranian elderly community relevancy to physical, mental and cognitive measurements.

A cross-sectional study with 422 participants, age 60 years old and over selected by face-to-face interviewing from the geriatric clinic, Tehran medical university from January to June 2019.

Of 422 participants referring to outpatient clinics the majority were male (62.8%); with an average of 66.9 ± 5.95 years old. Reliability was significantly high (Cronbach’s alpha = 0.96, p < 0.001). There was a significant relationship between IADL with Short-Form Health Survey36-Mental Component Score (SF36-MCS), with p < 0.01. Reliability was significantly high (Cronbach’s alpha = 0.96, p < 0.001). In the factor analysis with eigenvalues more than one, two components were found; that the first factor named as observational daily activities, whereas the second factor named “advanced daily activities”.

The limitation of this study was the low number of similar studies to compare the results and the stronger discussion.

Determining IADL's dependency in the community elderly is important to maintain their self-care manages. More studies are needed to manifest the relationship between mental health and IADL's independence. Therefore, validation in different settings is important in planning for the geriatrics team.

Currently, the health system is a treatment-oriented system focused on service providers. In this system, the main focus is on the health market, with little attention on insured. One way to get out of existing conditions is to empower the insured in order to involve them actively in maintaining and improving health. The paper aims to discuss these issues.

This qualitative study was done using the content analysis method. Based on the purposive sampling method and theoretical saturation criterion, 24 individuals including 12 health insurance experts and 12 insured participated in the study in 2018. The semi-structured interview method was used to collect data. Data were analyzed using MAXQDA10 software.

Having analyzed the interviews, 750 codes were obtained. These codes were categorized into two categories of “insurance experts” and “insured” and ten subcategories of “informing and educating, cost reduction, intersectional activities, expectations from the insured, services package, access to services, inability to pay costs, participation, and expectations from the insurance organization.”

This qualitative study was conducted to assess and determine the effective strategies for empowering the insured under health insurance. The results of this study are helpful to the health insurance organizations and health decision makers to detect the effective ways to develop the quality of insurance services, improve the status of insured, and increase access to health care goods and services.