Another issue in the HSEP involved informal payments in the medical community.
This study, thus, seeks to answer three main questions: (1) What is the percentage of households facing CHE after the implementation of the HSEP in the city of Sanandaj?
Piroozi et al study carried out in the province of Kurdistan in 2015 showed that OOP cost-sharing by inpatients for hospital bills in hospitals affiliated to MoHME reduced from 24% to 3% before and after the implementation of HSEP, respectively.
Our study was performed in Sanandaj city, located at west of Iran, so this might not be a representative picture of CHE status after implementation HSEP in Iran.
HSEP was prepared by maceration of 500 g of fresh calyces with 71 of 30% ethanol (v/v) at 20 [degrees]C for 7 days.
Briefly, 100 mg of HSEP was dispersed in a 1:1 water/methanol solution containing 2 N HC1, syringe-filtered through 0.
Inter- and intra-treatment comparisons were evaluated by two way analysis of variance (ANOVA) using the differences between pre- and post-treatment with interactions; being one factor the diagnosis (either control or MeSy) and treatment as the second factor (I: diet, II: HSEP, and III: diet plus HSEP).
PRE-TREATMENT DIET n = 27 HSEP n = 26 SBP (mmHg) 119.
The second phase of the HSEP (started on May 22, 2014) focused on the PHC and public health areas, included the following programs:
Updated relative value units (RVUs) of health services was launched at the third phase of the HSEP (September 29, 2014) in order to regularize public and private service providers' payments based on the articles 32 and 38 of the fifth 5-year development plan.
Based on the monitoring reports of the National Institute of Health Research, it seems that general population are satisfied with most of the HSEP components and the satisfaction has increased slightly during the first year of the program.
34,35) This is not an easy to achieve goal because of the high rate of tax evasion and size of the underground economy in Iran, (36) however, policy-makers and managers should define specific objectives to gradually replace current sources of HSEP by other sources that are progressive.