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Studies show that economic sanctions have had major negative impacts on health systems during the past years. The aim of this study is to identify the impacts of US sanctions on the performance of public hospitals in Iran.

A qualitative research study was conducted between October 2019 and September 2020 in Kermanshah Province, Iran. Semi-structured, face-to-face interviews, lasting between 25 and 90 min, were carried out with 20 participants in seven public hospitals affiliated to the authors’ institution in Kermanshah Province. Inductive thematic analysis was used to identify themes in the data.

Five main themes emerged from the analysis: resource management challenges; financial restrictions; interruptions in planning; reductions in the quality of service delivery; and changes in organizational relationships.

The results of the present study demonstrate that US economic sanctions have considerably reduced access to necessary medical equipment and medicines for public hospitals in Iran. Policymakers should monitor the distribution of equipment and pharmaceutical products within public hospitals in Iran and take actions to ameliorate shortages during times of economic sanctions.

Poor health-related quality of life (HRQoL) is one of the important issues in the health sector. The purpose of this paper is to investigate the prevalence and socio-economic inequality in poor HRQoL in Tehran city, Iran.

In total, 562 adults were included in this cross-sectional study. The cluster sampling method was used for data collection from May to June, 2016 in Tehran city, Iran. Data on HRQoL, using EuroQol 5-dimensions questionnaire, and data on socio-economic and demographic variables were gathered. Convenience regression method was performed to measure the concentration index (CI). Decomposition analysis was performed to determine the contribution of variables on socio-economic inequality in poor HRQoL. All analyses were performed by Stata v.14.

The prevalence of poor HRQoL was 28.3 percent. The value of CI for “poor HRQoL” was −0.299 (95% confidence interval: −0.402 to −0.195). Socio-economic status (SES) was the largest contributor to socio-economic inequality in poor HRQoL (69.44 percent of inequality was explained by SES). Age, obesity and race had a positive contribution to socio-economic inequality in poor HRQoL among the participants. Nonetheless, sex and smoking intensity had a negative contribution to inequality in poor HRQoL.

There is little evidence about the prevalence of poor HRQoL in insured people. This study provided new evidence in this area through the investigation of socio-economic inequality in poor HRQoL and its determinants among people with health insurance in Iran using decomposition analysis.

Education is a human right and access to high quality education is key to sustainable socioeconomic development. Improving the quality of higher education institutes is essential for generating the productive human resources. Assessing the quality of higher education from the students’ perspective can be considered a crucial factor in the monitoring of service quality in universities. The purpose of this paper is to evaluate the quality of educational services in a higher education institute, the Kermanshah University of Medical Sciences (KUMS), in the west of Iran.

A multistage sampling method was used to select 346 students from the KUMS, who were enrolled in the second semester of the academic year 2015-2016. The SERVQUAL questionnaire was used to gather data on students’ perceptions and their expectations about the quality of educational services. The authors used a statistical significance level of 0.05 to examine the gap between the students’ expectations and their perceptions of service quality in five dimensions, namely tangibles, responsiveness, reliability, empathy and assurance.

The results showed that there was a negative service quality gap in all five dimensions. The overall mean score of students’ expectations and their perceptions was 3.19±0.44 and 2.4±0.45, respectively. The score gap between the overall mean score of perceptions and expectations of students was −0.79, which was statistically significant (p<0.0001). The highest and lowest quality gaps were related to the assurance (−0.84) and tangible (−0.70) dimensions, respectively.

The study indicated that the quality of educational services provided in the KUMS did not meet students’ expectations in five dimensions of service quality. Thus, it warrants further investigations to determine how to improve the quality of educational services in higher education institutes such as the KUMS.

The Health Sector Evolution Plan (HSEP) is the most recent reform in Iran’s health care system that was launched in May 2014 in all university-affiliated hospitals to reduce health care expenditure for patients, while improving the efficiency and quality of hospital services. The purpose of this paper is to evaluate the impact of the HSEP on the performance of 15 hospitals affiliated with Kermanshah University of Medical Sciences (KUMS), located in the western region of Iran.

The Pabon Lasso model was used to measure the performance of hospitals before and after the implementation of the HSEP in 2013-2014 and 2015-2016, respectively. Three indicators of average length of stay (ALoS), bed occupancy rate (BOR) and bed turnover rate (BTR) were analyzed by the Pabon Lasso model.

The results showed that the average ALoS, BTR and BOR before the introduction of the HSEP were 2.59 days, 92 times and 57 percent, respectively, and the corresponding figures for these indicators after the implementation of the HSEP were 2.61 days, 98.9 times and 59.9 percent. The results indicated that before the introduction of the HESP, 40 percent of hospitals were in zone 1 (poor performance: low BTR and BOR and high ALoS), 27 percent in zone 2, 20 percent in zone 3 (good performance: high BTR and BOR and low ALoS) and 13 percent in zone 4. After the HSEP, the proportion of hospitals in zones 1-4 was 33, 27, 20 and 20 percent, respectively.

This study is the first to use the Pabon Lasso model technique to evaluate the impact of the HSEP on hospitals affiliated with KUMS.