Background and objective:Equality in distribution of health care facilities is the main cause for access and enjoyment to the health. The aim of this study was to examine the regional disparities in health care facilities across the Markazi province.Methods:This was a cross-sectional study. Study sample included the cities of Markazi province, ranked based on 15 health indices. Data was collected by a data collection form made by the researcher using statistical yearbook. The indices were weighted using Shannon entropy. Finally, technique for order preference by similarity to ideal solution (TOPSIS) was used to rank the towns of the province in terms of access to health care facilities.Results:There is a large gap between cities of Markazi province in terms of access to health care facilities. Shannon entropy introduced the number of urban health centers per 1000 people as the most important indicator and the number of rural active health house per 1000 people as the less important indicator. According to TOPSIS, the towns of Ashtian and Shazand ranked the first and last (10th) respectively in access to health services.Conclusion:There are significant inequalities in distribution of health care facilities in Markazi province. We propose that policy makers determine resource allocation priorities according to the degree of development for a balanced and equal distribution of health care facilities.

Background:Financial management and accounting reform in the public sectors was started in 2000. Moving from cash-based to accrual-based is considered as the key component of these reforms and adjustments in the public sector. Performing this reform in the health system is a part of a bigger reform under the new public management.Objectives:The current study aimed to analyze the movement from cash-based to accrual-based accounting in the health sector in Iran.Patients and Methods:This comparative study was conducted in 2013 to compare financial management and movement from cash-based to accrual-based accounting in health sector in the countries such as the United States, Britain, Canada, Australia, New Zealand, and Iran. Library resources and reputable databases such as Medline, Elsevier, Index Copernicus, DOAJ, EBSCO-CINAHL and SID, and Iranmedex were searched. Fish cards were used to collect the data. Data were compared and analyzed using comparative tables.Results:Developed countries have implemented accrual-based accounting and utilized the valid, reliable and practical information in accrual-based reporting in different areas such as price and tariffs setting, operational budgeting, public accounting, performance evaluation and comparison and evidence based decision making. In Iran, however, only a few public organizations such as the municipalities and the universities of medical sciences use accrual-based accounting, but despite what is required by law, the other public organizations do not use accrual-based accounting.Conclusions:There are advantages in applying accrual-based accounting in the public sector which certainly depends on how this system is implemented in the sector.

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IntroductionFair distribution of hospital beds across various regions is a controversial subject. Resource allocation in health systems rarely has focused on those who need it most and, in addition, is often influenced by political interests. The study assesses the distribution of hospital beds in different regions in Tehran, Iran, during 2010–2012.MethodsThis cross-sectional study was conducted in all regions of Tehran (22 regions) during 2010 to 2012. All hospital beds in these regions are included in the study. Data regarding populations of each region were obtained from the Statistics Center of Iran. According to the data, the total number of beds (N.B) and population (P) in 2010 (N.B=19075, P= 7585000), 2011 (N.B=21632, P= 9860500), and 2012 (N.B=21808, P=12818650). The instrument was a form, including the name of the hospital, the district in which the hospital was located, the number of staffed beds, the name of each region, and its population. Data analysis was performed using DASP software version 2.3.ResultsThe results demonstrate that the Gini coefficient of distributed beds in 22 regions of Tehran was 0.46 in all three years and specifically calculated 0.4666 in 2010, 0.4658 in 2011 and 0.4652 in 2012. The Gini coefficient of beds in 22 regions of Tehran is not fair in comparison with the population of each region during the years 2010 to 2012.ConclusionThe results demonstrate that the distribution of beds in regions in Tehran is not fair in relation to the population of each region—and some regions had no hospitals. Therefore, it is essential for policymakers to frequently monitor this issue and investigate the fair distribution of hospital beds.

Background: A four-step map of financial reform in Iranian health sector has been proposed with the aim of increasing efficiency and resource allocation. Objectives: This study was conducted to investigate the necessary requirements to establish the three last phases of this reform in Iran, during year 2015. Methods: A qualitative study in the form of framework analysis approach was conducted. An interview guide was used for interviewing 22 purposefully selected experts individually in a semi-structured format and data were saturated at this level. Data were analyzed using five-stage method of framework analysis (familiarization, identifying a thematic framework, indexing, charting and mapping, and interpretation) using the Atlas Ti software, by two experts with no conflicts of interest. Results: Six main themes and 18 sub-themes were extracted that introduced six groups of requirements including economic, functional, legal, organizational, informational, and educational, as the most vital needs for conducting financial reform in the Iranian health system. Conclusions: Findings showed that there are numerous problems with conducting financial reform despite spending a decade after its implementation in the Iranian health system. Therefore, the current results as well as planning to recognize and promote the modifiable parts in this field might be beneficial for policy-makers of the country to make a definite plan for revising this process with drafting a long-term perspective and a tailored context for complete and successful executing.