Journal of Rafsanjan University of Medical Sciences

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Background and Objectives: One of the main aims in Health Care Reform Plan is improvement of justice in household’s financial participation that its tool is reduction of out-of- pocket payment. This study was conducted to compare out- of- pocket payment for aortic valve replacement (AVR) surgery before and after implementation of the Health Care Reform Plan in Shiraz Namazi Hospital in 2016.
Materials and Methods: This descriptive study was conducted on 127 patients (50 patients before and 77 patients after the implementation of the plan) that  underwent AVR surgery. The data were collected through the researcher’s checklist and were analyzed using independent t-test and one-way ANOVA. 
Results: Total expenditure mean has increased significantly from 45,695,137.06 to 156,536,031.8 after the plan (p>0.001). The ratio of patients’  payment to total expenditure decreased significantly from 17.67% to 7.64% after the plan (p<0.001). The out -of- pocket  payment reduced significantly after adding the plan’s share in patient’s billing (p>0.001). Out-of-pocket payment on total expenditure ratio decreased for different insurances as 9% (p= 0.003) for Remedial Services Insurance to 11% (p<0.001) for Social Security Insurance.
Conclusion: The amount of out-of-pocket payment percentage of patients has been reduced for AVR surgery after implementation of the Health Care Reform Plan, which can be an  indication of the effectiveness of the out-of-pocket reduction  instructions. However, the average of  patients’ out-of-pocket payment  has been increased.
Key words: Out of pocket, Health Care Reform Plan, Aortic valve replacement surgery, Shiraz
 
Funding: This study was funded by Shiraz University of Medical Sciences with the grant number of 1396-01-68-16652.
Conflict of interest: None declared.
Ethical approval: The Ethics Committee of Shiraz University of Medical Sciences approved the study. (1396-01-68-16652)
 
How to cite this article: Kavosi Z, Ghodrati J, Yusefi RA. Comparison of Paying Out of Pocket for Aortic Valve Replacement (AVR) Surgery Before and After the Implementation of Healthcare Reform in Shiraz Namazi Hospital in 2017. J Rafsanjan Univ Med Sci 2018; 17 (7): 657-68. [Farsi]

Keywords: Out of pocket, Health Care Reform Plan, Aortic valve replacement surgery, Shiraz

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