The Effects of Health System Reform Plan Implementation on the Performance Indicators of Public Hospitals

Background: The health system reform plan (HSRP) is one of the recent reforms adopted in the health system of Iran. Objectives: This study aimed to investigate the effect of implementing of the HSRP on the performance indicators of teaching hospitals in Iran. Methods: This descriptive-analytic study was carried out in 10 teaching hospitals of Shiraz University of Medical Sciences in 2017. Afterreferringtotheconcernedhospitals,10performanceindicatorswereextractedandanalyzedat2stages(before(2013)andafter (2015) implementing of the HSRP). Paired sample t-test was run in the SPSS software23 to compare the obtained data. Results: Investigating the mean differences of performance indicators before and after the implementation of the HSRP indicated a significant increase (P < 0.05) for the indicators of bed occupancy ratio, inpatient to constructed beds ratio, the mean length of stay,frequencyof patientsadmittedintheclinicalandparaclinicalsectors,frequencyof emergencyandelectiveoperations,aswell as frequency of cesarean and normal delivery. However, the hospital bed turnover rate revealed a significant decrease compared to the year prior to the implementation of the HSRP (P < 0.05). Conclusions: The implementation of the health reform plan has been accompanied by significant changes in the performance indicators of the hospitals. Regarding the reduction of the normal delivery rate in comparison with caesarean section after the implementationof theplan,itissuggestedtoimprovetheawarenessandcultureof mothersandsocietyregardingtheimportance and benefits of natural delivery through the intersectional interactions.