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Introduction: Health is one of the natural rights and basic human needs and is recognized as one of the prerequisites for social welfare systems. However, Lack of financial health protection is recognized as one of the diseases in health systems. When the eleventh government get start, the Ministry of Health developed the health sector reform to seek financial protection from the people. The purpose of this study was to investigate the effect of Health System Reform on Patients’ Formal Payment in Heart Sector of Qazvin’s velayat Hospital.
Methods: This was a comparative study of discontinuous time series. The bills of all patients referring to the heart department during the specified period formed the statistical population of the study. By using Morgan table and stratified random sampling, 120 and 154 samples from cardiac files were selected in the years 2013 and 2014 respectively. Data were extracted from patient's financial bills.  Finally, data was analyzed by t-test and SPSS software.
Results: With the increase in health care tariffs during the plan implementation, the official payment of patients has not declined significantly, and new insurance mechanisms have prevented the development plan from reaching the goal of reducing the patient's direct payment to six percent of the bill.
Conclusion: Results of the study indicate the impact of various factors such as insurance mechanisms, health care tariffs and kind of patient insurance. Therefore, it is worth the government to use results of the study in planning to increase coverage and financial protection of the people.
 

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Introduction: The outbreak of Covid-19 canceled unnecessary hospital admissions. Therefore, hospitals face economic consequences. In this context, this research has investigated the effect of the Corona virus pandemic on the revenue of a hospital in Tehran.
Methods: This study is retrospective interrupted time series studies.In this time series study, the monthly revenue of all services provided by a hospital in Tehran was collected and analyzed in the form of a census in two groups before and during the Covid-19 outbreak. Data analysis was done using Eviews. Chow test was used to detect structural breaks in the studied time series.
Results: The findings of this study showed that the outbreak of Covid-19 reduced the revenue of all hospital services. According to the negative coefficient of the variable of the Covid-19 period and the regression coefficient, it indicates the existence of a negative relationship between the total revenue of the hospital and the prevalence of Covid-19. After the outbreak of Covid-19, the revenue of laboratory services and internal services decreased by 50% compared to the previous year after the outbreak of Covid-19 and continued to decrease by 20%.
Conclusion: The results of the study showed in the Covid-19 pandemic, with the change of admission priorities, the number of referrals decreased due to the fear of the hospital being infected with financial shocks. it is suggested that the hospital managers take action to train the forces, improve service productivity, reduce costs, and make optimal use of potential financial and human resources during the peace period.