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Health can be influenced by many factors. One of the factors is the political context of the country and democracy. The purpose of this paper is to examine the effects of freedom in press and polity index in overall, public, private and out of pocket health expenditures.

A long-term panel data approach has been used to examine the relationship between democracy and health expenditures. The authors inserted polity and freedom into press indexes in the health expenditure model.

Increase in freedom of the press and democracy will increase the overall, public and private health expenditures while they decrease out of pocket health expenditures.

Polity and freedom index has a significant impact on all the health expenditure models.

Valid and reliable measures are required for assessing patient satisfaction meaningfully. The purpose of this paper was to develop and validate a Persian-language in-patient satisfaction questionnaire for patients discharged from Iranian medical and surgical services.

The cross-sectional survey included 400 patients randomly selected from six Tehran hospitals. A total of 405 patients responded to the questionnaire (76.3 percent response). To assess inter-item reliability and construct validity, factor analysis was carried out. Items belonging to each factor and their Cronbach's alpha coefficient were calculated.

A total of seven dimensions were identified: doctor-patient communication; nursing care; convenience; visitors; cleanliness; costs; and general satisfaction. Together, these dimensions explained 60 percent of the variance. All items, except three, revealed loadings above 0.4, while Cronbach's alpha exceeded 0.8 for all dimensions, except visitors (0.66). Patient satisfaction levels were relatively high.

Results must be interpreted cautiously owing to high satisfaction, which should not be considered as comprehensive evidence of high performance without important additional service-performance information. Qualitative studies are recommended to complement the authors' quantitative satisfaction study.

The patient satisfaction questionnaire strives to be a valid and reliable instrument for assessing in-patient satisfaction with hospital services in Iran.

Equal distribution of health human resources is a major issue to achieve human rights in healthcare. Rural family physicians (RFPs) as a part of health human resources play an important role in delivering health services, so the purpose of this paper is to calculate amount of inequity in distribution of RFPs in Iran.

In this study, the authors tried to find inequity in the distribution of RFPs in the provinces of Iran. For this purpose, inequity indices containing concentration curves and indices were calculated by ranking health-adjusted life expectancy (HALE). Furthermore, a regression model was estimated to find the pattern and influencing factors of inequity in the distribution of RFPs.

The number of male RFPs was significantly higher in Sistan va Baloochestan, and in the same line, the number of female RFPs was higher in Zanjan province. Concentration index of total RFPs was 0.0568 (not significant) (males= 0.041, females= 0.0718). The results of regression model showed that HALE and per capita GDP did not have any significant relationship with RFPs distribution (HALE p=0.753, GDP p=0.792).

The RFP plan was successful in enhancing equal access to physician and health care services relatively. However, gender imbalance in distribution of RFPs was high especially in less-developed regions.