Journal of

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Abstract: Background: Today one of the main problems low or middle income families face is financing healthcare costs. This article studies the methods of of financing health care costs among hospitalized diabetic patients in different types of insurances. Materials & Methods: This is a causal-comparative study. The variables consist of comparative (health care costs) and categorical(different insurance types including: Iran health insurance , social security and others) variables. A researcher-made questionnaire was used to collect needed data . The data were analyzed by one-way ANOVA , Duncan`s statistical test test of Danken and T-test. Results: The results indicated a significant statistical differences between all types of insurance assessed by cost variables. Also the significant differences between patient`s out of pocket expenses ratio of direct costs (p<0.01،F=19.37) and their ratio of total costs (F=25.36, p<0.01) were detected in three types of insurances . Patient`s out of pocket of total cost was 59.55%, 50.34% and 32% in Iran health insurance, social security and other types respectively. Conclusion: In spite of all invested deal of efforts to improve health indices and health care services availability ,health care system is still faces main challenges of providing financial resources and protecting against financial burden on families . Developing a public health insurance and improving health insurance coverage would be helpful for providing financial resources of health care system.

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Background: Insurance companies sometimes do not reimburse hospitals completely. Reducing the amount of deduction of bills increases hospital’s income and efficiency. This study compares the deductions imposed by social insurance organization on Imam Khomeini hospital’s bills before and after the implementation of health transformation plan.
 
Material and Methods: Data of this descriptive-descriptive study calculated from the deductions applied to the hospital of outpatient and inpatient bills of social insurance organization in second six months of 2013 (before implementation of health transformation plan) and the same time of 2014 (after implementation of of health transformation plan). This quasi experimental study was conducted using the data. Data was analyzed by SPSS software using paired t test.
 
Results: The bill deductions in the second six months of 2013 compare to the same time in 2014 were 2.9 and 11.1 percent, respectively. Hospital bill deductions increased 282.8 percent after the health transformation plan implementation. The deductions on inpatients and outpatients records increased 6 and 12 times, respectively. Most deduction was imposed on surgical and laboratory bills in 2013 and on radiotherapy, chemotherapy and hoteling bills in 2014.
 
Conclusion: Deductions of hospital bills extremely increased from social insurance organization after implementation of health transformation plan. In order to identify deductions causes, providing related education to staff and physicians and relative process improvement are necessary.

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Introduction: Health tourism is one of the most lucrative and competitive industries in the world and is a new field of tourism. The purpose of this study is to present a conceptual model of health tourism development on community welfare.
Materials and Methods: This research is qualitatively exploratory. The study population included university professors and health tourism managers. Fifteen people participated in the study through purposive non-probabilistic sampling and through semi-structured and in-depth interviews. Data analysis was performed with MAXQDA10 software and a grounded theory approach based on three stages of open, axial and selective coding. To check the validity, two methods of participatory feedback and receiving the opinions of colleagues, and to ensure the reliability of the interviews, two methods of retesting and two coders were performed.
Results: The data analysis was based on 100 keywords (open source). By identifying the relationship between the codes, 18 common concepts were categorized. The main concepts were categorized according to the axial coding method. Because traces of medical and health facilities, health tourism infrastructure, and relationship development policies were seen in most of the interviewees' quotes, they were selected as the central sub-categories of health tourism and these three items were placed at the center of the model. And other categories were associated with it.
Conclusion: The development of health tourism is a tool for the development of society and increases investment in the political, social, cultural and economic sectors of society, creates employment, increases income and people's satisfaction and vitality, and promotes the development of welfare, the improvement of the quality of life and wellbeing.