Journal of Education and Health Promotion

Abstract INTRODUCTION: Protection against financial risks is one of the important goals of the health
system. The present study aims to determine the rate of exposure to catastrophic expenditures in
the insured inpatients.
METHODS: The present study was cross‑sectional one which is conducted in 2016. The statistical
population comprised all the insured patients presenting to a private hospital in Qom who presented
to the hospital within 4 months from December 2015 to March 2016. Random convenience sampling
method was used, and the sample size was estimated at 267 people using Cochran formula.
A questionnaire was employed for data gathering. Data were analyzed using Chi‑square test and
logistic regression using SPSS software version 20.
RESULS: Patients exposed to catastrophic expenditures of treatment accounted for the 54.8% of
the cases. The highest rate of being exposed to the catastrophic expenditures was related to the
insured patients of the Universal Health Insurance Fund (UHIF). People with rural insurance, on
average, paid the highest cost of treatment in the hospital. The surgical ward and critical care unit
accounted for the biggest percentage of the patients who incurred catastrophic expenditures. Being
rural, longer length of stay, lower education of the head of the household, lack of supplementary
insurance coverage, and being in UHIF coverage have a substantial relationship with being exposed
to catastrophic expenditures.
DISCUSSION: The socioeconomic status of the insured people in the UHIF and the Rural Insurance
Fund was worse than other funds in terms of less utilization and higher rate of exposure to catastrophic
expenditures, and this issue requires the adoption of specific targeted policies for these groups in
respect with reducing out‑of‑pocket payments through mechanism such as stepwise copayments,
maximum out‑of‑pocket limit, fee exemptions or waiver and providing supplementary insurance to
reduce the exposure to catastrophic expenditures.

Abstract CONTEXT: Health system reform plan refers to conducting some fundamental, systematic, and
sustainable changes.
AIMS: The aim of the present study was to evaluate different required inputs of Iran Health
Transformation Plan from experts’ viewpoints.
SETTINGS AND DESIGN: The data of this qualitative study were collected using semi‑structured
interviews.
SUBJECTS AND METHODS: The purposive sampling method led to 18 participant selection and
then they were interviewed. Interviewees were assured about confidentiality of information.
STATISTICAL ANALYSIS USED: The thematic analysis method and MAXQDA software were
employed for analyzing the data.
RESULTS: There were 4 main themes and 35 subthemes extracted including management
requirements for health development plan, human resources, information resources, and financial
resources. Each theme had subthemes such as “resource allocation,” “development of required
standards for human resources,” “human resources’ motivation,” “failures in IT infrastructures,”
“hospital information management software,” “guidelines and instructions,” “costs controlling,” and
“financing the plan”.
CONCLUSIONS: Results of the present study put significant emphasis on the path of improving
the effectiveness and efficacy of applying the discussed inputs, which can be a light for revising
past policies and taking better future steps, it also can be a resource guide for policy‑makers and
managers of the health‑care system.

Abstract Background and Objectives: Researchers believe that there are social exchanges
between the employers and employees, because the employees would be interested in
their organization and trust it based on how the organization values them and their welfare,
comfort, and security. This belief is known as perceived organizational support that makes
employees consider themselves as a part of their organization and have a commitment to it.
The literature review is very limited in both variables in Iran and thus few studies also report
the perceived organizational support and job involvement at the lower levels in our country.
This research aimed at studying the levels of perceived organizational support and job
involvement, relationship between this two, and the demographic factors relationship with both
of them. Materials and Methods: This research was a descriptive analytical study conducted in
2012. The population included 123 emergency nurses in General Hospitals of Qom. Data were
collected through Perceived Organizational Support and Job Involvement Questionnaires and
analyzed using SPSS software, descriptive statistics and Spearman correlation and Chi-square
test. Results: Both mean scores for perceived organizational support and job involvement
were in average level, 146/12 and 35/38, respectively. There was a significant relationship
between perceived organizational support and age, education, tenure, organizational position,
and job shift. There was also a significant relationship between job involvement and age
and education and finally between perceived organizational support and job involvement
(P = 0/029). Discussion: The high correlation between perceived organizational support
and job involvement indicates that the improvement of perceived organizational support are
necessary through motivating the employees, showing interest in them, paying attention to
them, respecting them, and providing development opportunity in the organization. These
should be always considered by managers
to improve job involvement