Improving the organizational structure of medical universities and the continuous adaptation to the mission and new functions is an irrefutable necessity. The current article aimed to explain how this improvement was happened in 2019 in Iran medical universities. Methods: It takes qualitative method with managers and experts from the Ministry of Health and 17 medical universities. Via the Snowball sampling method 57 people were interviewed by using semi-structured in-depth method. MAXQDA 2020 software was used for the content analysis. Results: The opportunity window was opened for medical universities to reform their organizational structure according the agenda of the Ministry of Health in 11th government. High-level documents and laws related to this subject, in addition to the cooperation of medical universities process owners and the Ministry of Health stakeholders and the formation of specialized working groups lead to formulate organizational structure (policy stream). Conclusion:Regarding to having a dynamic and flexible structure for meeting environmental needs, Iranian medical universities were modified in 2013 by Ministry of Health policymakers and managers. The Kingdon Multi-Stream Model helps to better understand the content of this policy.

Objective: The current study aimed to assess the factors associated with HRQoL and HU among Patients with diabetes in Zabol, Southeast Iran.  Methods: Among patients referred to Zabol city diabetes clinic, a total of 213 consecutive patients 18 years and older consent to participate in the study in 2015. The Persian version of EuroQol-5D-3L (EQ-5D-3L) using the UK preference weights was applied to derive HU. Logistic regression and ordinary least squares were used for data analysis. The STATA version 13 (StataCorp LP, College Station, TX, USA) was used for statistical analysis. Results: The highest and lowest proportions of "some or extreme problems" were seen in pain/discomfort (86.6%) and self-care (27.8%) dimensions of the EQ-5D-3L, respectively. About 33% of women and 14% of men rated their health worse than death (p=0.002). The mean EQ-5D-3L index score and visual analogue scale were 0.37 (95% CI: 0.31-0.42) and 51.6 (95% CI: 48.7-54.5), respectively. Older age at diagnosis, longer duration of diabetes, lower education, and history of macrovascular complications were associated with lower HRQoL and HU. Conclusion: This study highlights the importance of education and diabetes-related complications in HRQoL/HU of diabetes people. The findings suggest that urgent interventions are required to improve HRQoL/HU of diabetes patients in Zabol. Moreover, our results provide inputs for future economic evaluation studies among diabetes patients with similar socioeconomic status in Iran.