Tehran University Medical Journal

Background: Currently many hospitals around the country face increasing demands of their patients and readmission.The rate of readmission is a useful indicator for determining the performance of healthcare system and it shows the quality of services in the medical institutions. Readmissions have high economic, social and financial impact and studying the related factors seems to be high priority for healthcare systems.
Methods: This qualitative study performed by phenomenological method in three educational hospitals in Kerman from April to September of 2017. Data collection was performed through semi-structured interviews using targeted sampling among all patients who were hospitalized at internal medicine wards, nurses who were working in those wards, and in charge physicians. In total twenty patients, fifteen nurses, and five physicians were selected for interviews. The including criteria were for patients, the history of hospitalization at least once, during one month after the initial hospitalization, and for service providers, familiarity with the subject, work experience in the relevant department of at least three years for nurses and five years for physicians. A seven-step clustering method was used to analyze the data.
Results: The analysis of the interviews led to the identification of three main themes and 11 sub-themes. The main themes included patients' characteristics, manpower and clinical factors, hospital, and environmental factors. Some of the sub-codes included economic and living conditions, marriage status, insurance coverage, patients' beliefs and expectations, the presence or absence of underlying disease, education, lifestyle habits, dietary beliefs of hospitalized patients, lack of trust in medical staff, communication and cultural barriers, ignorance of service providers in treatment, lack of facilities, lack of motivation in medical staff, stressors and finally lack of hospital equipment.

Background: Health insurance literacy is a nascent concept that has emerged mainly after the implementation of the law known as Obamacare in the United States. This study seeks to identify the themes of health insurance literacy in Iranian society.
Methods: The study approach is qualitative. Data were collected using nine semi-structured interviews, ten focal group meetings with the presence of 86 experts of an insurance organization and a specialized meeting with fifteen academic experts, from September to December 2018 at the organization's location. MAX QDA10 software was used to organize the data. Qualitative data analysis was performed using continuous comparison analysis and in the form of directional qualitative content analysis based on the conceptual model (Paez et al 2014). Coding was performed independently by two researchers and then collected. Results were reviewed by an external observer. Finally, in a specialized meeting with the participation of representatives of specialized (groups secretaries) and academic experts(participants in the initial interviews), the findings of the study were re-examined and confirmed