OBJECTIVESThe health transformation program was a recent reform in the health system of Iran that was implemented in early 2014. Some of the program’s important goals were to improve the equity of payments and to reduce out-of-pocket (OOP) payments and catastrophic health expenditures (CHE). In this study, these goals were evaluated using a before-and-after analysis.METHODSData on household income and expenditures in Guilan Province were gathered for the years 2013 and 2015. OOP payments for outpatient, inpatient, and drug services were calculated, and the results were compared using the propensity score matching technique after adjusting for confounding variables. Concentration indices and curves were added to quantify changes in inequity before and after the reform. The incidence of catastrophic expenditures was then calculated.RESULTSOverall and outpatient service OOP payments increased by approximately 10 dollars, while for other types of services, no significant changes were found. Inequity and utilization of services did not change after the reform. However, a significant reduction was observed in CHE incidence (5.75 to 3.82%).CONCLUSIONSThe reform was successful in decreasing the incidence of CHE, but not in reducing the monetary amount of OOP payments or affecting the frequency of health service utilization.

IntroductionPreparedness of hospital has a major impact on their optimal and satisfactory performance. This study aimed to investigate the preparedness of the hospitals to deal with disasters.Case PresentationThis cross-sectional study was carried in 2011 and all of the hospitals which were located in the northern areas of Iran were investigated through the census method. The data collection instruments were self-administered Managers’ Awareness Questionnaire (40 items) and a 141-item checklist. The mean percentage score of hospitals in management of the unanticipated disasters program in the hospital was good. The mean score of managers’ awareness of the hospital status was moderate. With the increase in managers’ awareness, the preparedness of the hospitals significantly increased (r = 0.73, P < 0.001).ConclusionsThe findings showed the moderate preparedness of the hospitals in the Northern provinces to deal with disasters.

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Background: Addiction is a primary, chronic disease of brain reward, motivation, memory and the related circuitry. Objectives: The purpose of the study was the measurement of effective components in addiction relapse, in Rasht city of Guilan province, Iran. Patients and Methods: This study was done in 2014 that has been performed by using the factor analysis method. In the qualitative stage the process owners were 45 experts, and in the factor analysis stage they were 1850 people who were under treatment at addiction treatment centers. The data collection tool was a Researcher-Made Questionnaire whose content validity was determined through expert panel, and its construct validity was determined through exploratory factor analysis by principal component analysis method with varimax rotation using SPSS16 software. Results: In exploratory component analysis, 4 main components were identified; Individual factors with 6 variables, 25.72% variance, and 17.81 eigenvalue as the most important factor, and Economic factors with 5 variables and 7.64% variance as the less important factor, clarified the Addiction Relapse changes; however, in the fitted model which is the most completely saturated model, 4 factors of Individual factors with ß = 0.48, family factors with ß = 0.23, occupational factors with ß = 0.2, economic factors with ß = 0.12 had the highest predictive power in the order of importance. Conclusions: According to the findings, individual, familial, social, cultural, and economic factors were the most important in relation to the addiction relapse.