Examining the Effect of Executing the Health Reform Plan on the Share of Insurances, Franchise, and Health Subsidies in Shahid Sadoughi University of Medical Sciences in Yazd in 2013-2016

Abstract

Background: The Health Reform Plan was begun in 2014 as one of the most significant programs of the Ministry of Health to reduce hospitalization and out-of-pocket costs paid by people. Hence, we consider examining the economic consequences of this plan as one of the research priorities in this field. This study aimed to examine the effect of implementing the Health Reform Plan on the share of basic, supplementary insurances, franchise, and health subsidies from medical expenses in Shahid Sadoughi University of Medical Sciences in Yazd in 2013-2016. Methods: This study is a descriptive study conducted in a quantitative and cross-sectional method. The study population included patients' bills in hospitals affiliated to Shahid Sadoughi University of Medical Sciences in Yazd. All patient's hospitalization files were examined by the census method. Information was extracted from financial documents and data in the hospital's HIS system. We referred to the basic and supplementary insurance organizations of the province to complete the data. Descriptive statistics and were used to analyze the obtained data by using SPSS16 Software. Results: Generally, it was specified that the share of basic and supplementary insurances had not changed considerably due to the doubling of the whole costs of patients 'files, and basic insurances will pay on average 76 % of patients' costs. But, the patient's share of out-of-pocket payments has declined from 21 % to 11 %, which the Ministry of Health and Medical Education will pay this 10 percentage through the health subsidy to the affiliated centers. Conclusion: This study's results explained an increase in patient's health costs and a decrease in patient's out-of-pocket costs. Consequently, it is required to pay attention to methods to increase medical centers' efficiency to reduce health costs. Furthermore, large-scale/macro programs should be designed and implemented at the national level to reduce patient's out-of-pocket payments.