Journal of Education and Health Promotion

Abstract INTRODUCTION: Iran’s Health System Reform Plan (HSRP) were initiated in public and hospitals
affiliated to Medical Sciences Universities in June 2015. The purpose of the present paper is to
provide a critical analyse of the HSRP and its outcomes.
METHODS: The study was carried out as a review critical analyse in 2019. The pertinent articles
were searched for in Science Direct, PubMed, Ovid, and Google Scholar using keywords “health
sector,” “reform plan,” “health system reform,” “health services,” “health care system,” and “Iran.”
Published articles in scientific national and international journals in Persian and English language,
of which the full‑texts were available, were entered into the study. Finally, from a total of 75 articles
obtained, 45 studies were carefully reviewed.
RESULTS: Several factors, which impact in the success of Iran’s HSRP such as social‑economic and
political outlooks, lack of official information and a comprehensive management system, in addition
to failure to extend continuous performance control, economic sanctions against Iran. Other factors
are limitations on financial transactions between Iran and the rest of the world due to the sanctions,
relying merely on a few instructions, and negligence of the required infrastructures. In terms of
advantages of the plan, relative decrease in patient’s share in medical expenses, improvement of
emergency wards, and relative decrease in the rate of C‑section operations are notable.
CONCLUSION: Better implementation of Iran’s HSRP entails the provision of resources and facilities
such as stable and adequate resources, proper management of available resources, payment
mechanisms reform, attracting, and facilitating private sector’s participation.

Abstract INTRODUCTION: Hospital care transformation plan (HCTP) was implemented, in 2014, with the aim
of ensuring all Iranians have fair access to hospital care, mainly in the public sector. It was assumed
that HCTP would lead to increased quality and effectiveness of health care in public hospitals. To
explore whether HCTP has achieved its aim, this study has investigated the impact of this plan on
performance indicators (PIs) of the public hospitals.
MATERIALS AND METHODS: This cross‑sectional descriptive study was conducted in 2016. The
study population included all hospitals in the Isfahan City. Data (10 selected PIs) were collected
through formal reports which were available at the Isfahan University of Medical Sciences and
analyzed using Statistical Package for Social Sciences (version 17). The statistical significant level
analysis was 0.05.
RESULTS: After HCTP, it was shown an increase of (1) Bed occupancy, bed turnover, occupied
bed‑days, inpatients visits, and number of surgeries in all types of hospitals, (2) Outpatients’ visits in
all hospitals except private ones, (3) Emergency visits in public and social security hospitals, and (4)
Natural deliveries in public and semi‑public hospitals. Furthermore, the average length of stay and
hospital mortality rate has decreased in all types of hospitals after HCTP implementation.
DISCUSSION AND CONCLUSION: Although, improving PIs of hospitals were not directly stated
and known objectives of HCTP implementation, it seems HCTP could improve the performance of
all hospitals, including involved and noninvolved ones.