محمود کیوان آرا

Experts, consider the current Psychological well-being, as a fairly accurate indicator of a person's current health status. The aim of this study was to compare psychological well-being in employed and non-employed women in Isfahan.

This research is applied in terms of purpose, descriptive-analytical, and cross-sectional. The statistical population is all women aged 20 to 60 years in Isfahan in 2021, the number of samples for each employed and non-employed women was 394 which was selected by available sampling method. The standard Warwick and Edinburgh Mental Welfare Questionnaire was used for data collection and SPSS26 software was used for data analysis.

The mean ranks and sum of ranks for psychological well-being, positive relationships with others, and energy levels are higher among working women compared to non-working women. Significant differences exist between working and non-working women in these variables, indicating that working women generally experience higher levels of mental well-being, positive relationships, and energy (P≤0.001). However, the mean ranks and sum of ranks for optimism among non-working women are slightly higher than those among working women, although this disparity is not statistically significant (P=0.955).

The results show that employed women have better psychological well-being compared to non-employed women in Isfahan. This issue can be used by policy makers to develop appropriate strategies for women's employment. Policymakers and managers of organizations, by identifying and understanding the factors affecting the increase of women's psychological well-being, will be able to use scientific methods to adopt policies to promote women's psychological well-being.

Women in every society play a central role in the family and at the same time, are highly exposed to the pressures of dysfunctional relationships of economic, social, and cultural institutions outside the family, and if they are constantly exposed to traumatic and critical conditions, they may inflict irreparable damage on themselves in an unwanted helplessness, and by unacceptable behaviors such as violent suicides including self-immolation, endanger their survival as well as that of their family. Accordingly, this study was conducted to identify the social contexts of self-immolation among women admitted to Isfahan Burns Hospital, Isfahan, Iran.

This study was a qualitative content analysis which was conducted on 43 women hospitalized in Imam Musa Kazim Hospital in Isfahan due to self-immolation. Participants were purposefully selected and individually interviewed in a semi-structured interview. Data were categorized and analyzed by qualitative content analysis or thematic analysis.

Totally, the study identified 157 primary codes which were reduced to 16 secondary codes and 5 main concepts including conflict in family, addiction, marriage, poverty and economic difficulties as well as individual and psychological problems were obtained.

The problems of women who attempt self-immolation are related to harassment and dissatisfaction with at least one of their close relatives or difficult and stressful living conditions. The results of this study can be used for national planning by the relevant agencies to respect the rights and security of women in the family and society.

The goals of global growth of the elderly population and ensuring the health of the elderly is a global event and one of the most important challenges of the health system of countries, especially developing countries and Iran; In this regard, the study was conducted to explain the challenges of the Iranian health system in the face of future aging.

The study was qualitative content analysis. A total of 29 experts from various disciplines including geriatrics, psychology, social medicine, nursing, medicine, health and social welfare, health policy, health care management and health economics participated in the study. The data obtained from the semi-structured interview were classified by the content analysis method. Lincoln and GABA criteria were used to assess validity.

In identifying the challenges of the Iranian health system in the face of future aging Two general concepts including "policy challenges" including "barriers related to planning and implementation", "financial barriers", "vision barriers", "therapeutic barriers", "Health barriers", "educational barriers" and "individual social challenges" were identified, including "cultural value barriers", and "individual barriers".

The frequency and variety of challenges of increasing the elderly population in the country according to the findings of the study indicate the critical state of the health system in the near future. Identifying these challenges can be used by policymakers and planners for any planning and action.

Infectious diseases in the pandemic stage have significant life-threatening, psychological and social effects. Identifying the characteristics associated with peoplechr('39')s cooperation in self-care leads to greater immunity for themselves and others. Therefore, this study was conducted to predict the self-care of the Iranian people according to their individual and social characteristics in face of the Covid-19 pandemic.

A survey study was conducted on 1056 adults aged 18 and over in different provinces of Iran through a form of answering online researcher-made questions (n=40, α=0.9) in social networks in four days. This paper studies the level of self-care of people against Covid 19 pandemic which was conducted with the support of Isfahan University of Medical Sciences in April 2016. Data were analyzed using Student t-test and variance. Moreover, "decision tree technique" was used to identify communication patterns.

The findings showed that the average self-care score in women, the most educated, married women, women aged 41 to 55, housewives and some other occupations was very high. However, the average self-care score of single men with a diploma was average. In general, the mean score of womenchr('39')s self-care was higher than men (P<0.0001) and the educated were more than the less educated literate (P=0.007). There was no significant difference between the self-care scores of the respondents in terms of their marital status and employment.

The results showed that the average scores of self-care in women, more educated people, married women, women in the age group of 41 to 55 years, housewives and some other occupations were reported to be very high; While the average self-care score reported in single men with a diploma was average. Overall, the mean score of self-care reported in women was higher than men (P<0.0001) and people with doctoral education reported more self-care than illiterate people (P=0.007). Besides, there was no significant difference between the self-care scores of the respondents in terms of their marital status (single and married) and their employment status (employed and non-employed).

The recent Coronavirus (SARS-CoV-2) has resulted in a sudden outbreak which has significantly affected various aspects of daily lives. This study was carried out to determine self-care barriers in prevention of Covid-19 according to healthcare experts and laypersons.

A qualitative-quantitative based cross-sectional research was designed. To perform the qualitative phase, group discussion with faculty members and managers in Isfahan University of Medical Sciences and phone interviews with laypersons were carried out. Then, data extracted in this phase were used to design a 40-item questionnaire which was found to be reliable (Cronbach’s Alpha: 0.90), to be completed by Iranian citizens in four days via social networks. In this survey, 1056 people participated. Data analysis was done in SPSS V21.

Self-care barriers according to the qualitative phase of the study included social barriers, psychological barriers, religious barriers, political and management barriers, healthcare system barriers, and information barriers. Political and management barriers (mean score=78.87) and psychological barriers (belief, behavior, personality) (mean score=70.01) were found to be the major self-care barriers. The mean self-care score was 8.5 (in a scale of 0 to 10). The mean self-care scores were significantly higher in women (P<0.0001) and in people with higher levels of education (P=0.007). No significant difference was observed in mean self-care score based on marital status (P=0.61) and occupation (P=0.052).

Health care managers and policymakers could guide people towards more efficient self-care by planning to reduce and overcome barriers identified in this study.

The higher medical education system’s mission is to maintain and improve the health in society. Furthermore, the roles of social determinants of health in health situation of society have been emphasized, and require in-depth and expansive studies. Therefore, the current study aimed to identify the position of social determinants of health in higher medical sciences education system.

This study was conducted using qualitative approach with 20 experts in focus group discussion, and 8 experts in semi-structured interviews. The gathered information was reported using qualitative content analysis approach using codes, subcategories, and main categories.

The findings of focus group discussion and semi-structured interviews with experts resulted in 500 codes, 17 subcategories, and 4 main categories of education, policymaking, legislation, and implementation, participation and accountability in public and private sectors, and weakness in areas related to social determinants of health.

The findings of this study play a strategic role in medical education system for identification and expansion of social determinants of health. These findings can be used by policymakers, planners, and executives of education system to apply the teachings provided in medical education system, and create a more focused and productive system in the area of social determinants of health.

Equal distribution of human resources in health sectors was one of the main aspects of Alma-Ata Declaration (2000). Since physicians are among the skillful human resources in health sector, optimal allocation of medical specialties has been always a challenge for policy makers. Distribution of general medicine physicians and specialties is related to medical students’ preferences for speciality choice. This study aimed to identify the factors affecting preferences in choosing medical specialty.

This was a qualitative study based on the grounded theory. Through apllying snowball sampling, participants were selected from senior medical students of Isfahan University of Medical Sciences in the academic year 2016/2017and 28 interviews were conducted. Data analysis was done based on thematic analysis and applying MAXQDA18 software.

We extracted 4 main themes and 10 subthemes. Main themes included students’ perception of the medical specialties, students’ characteristics, medical specialties’ characteristics, and social conditions. 

In order to attract medical students to more needed medical specialities and optimal distribution of specialities, policy makers should consider both individual and social determinants of medical specialty choice.

Despite all the advances, cancer is still a deadly disease. An important solution in encountering, confronting, and overcoming this deadly disease is hope among the patients. The purpose of this study was to examine the relationship between social capital and hope in patients with cancer.

Research method was survey, and the population was patients with cancer in Seyyed-o-Shohada Hospital in Isfahan that 118 cases were selected through multi-stage random sampling method from Chemotherapy, Men’s ward, Women’s ward, Men's surgery, and Women's surgery. Research instruments to measure social capital was Onyx and Bullen's (2000) questionnaire, and to assess hope, Snyder’s (1994) hope to future questionnaire was applied.

Based on the findings of the study, the hope for future is average among patients with cancer in Seyyedol Shohada Hospital in Isfahan. The results of structural equation modeling showed that, social capital has a positive and significant (P = 0.010) relationship with hope to future and able to explain 56 percent of the variation of the dependent variable.

With teaching social capital and increasing it, hope to future among patients with cancer can be promoted and one of the main challenges of the health and therapy system in Iran, cancer deaths, would be alleviated.

Holdingcontinuing medical education programs (CME) is one of the recommended global strategies for attaining rational drug prescribing by physicians. The aim of this study was to assess the barriers and fill the gap between the current situation and the favorable status of CME by evaluating experts’ viewpoints on the role of these programs in improving the status of drug prescribing.

This qualitative study was conducted using a semi-structured interview. Participants included those who were well-informed and experienced in the field of rational use and prescribing drugs. Sampling was done in a targeted way and 16 people were interviewed. The interviews were evaluated after the implementation of the theme analysis method.

 In this study, two major concepts including the needs for CME and barriers to effective CME were presented by the participants. The needs for CME included 4 main themes, and the barriers to effective CME included 6 themes (physical, financial, motivational, supervisional, executive, and policy making barriers) and 12 sub themes.

 Regarding the multiple barriers to achieving the effective CME and improving the rational drug prescribing, and in order to overcome these barriers and achieve a favorable status, a review of the content and quality of CME, outcome-based planning, and continuous quality promotion are required.

Irrational use and prescribing of medications is a major problem in healthcare systems worldwide. The factors affecting prescribing and use of drugs can be assessed in educational, management, supervision and financial areas. Present study was designed to investigate the role of financial incentives in this field.

This qualitative study was conducted using a semi-structured interview in 2016. Participants included those who were well-informed and experienced in the field of rational use of drug. Sampling was done in a targeted way and 16 people were interviewed. Interviews were evaluated after the implementation of the theme analysis method.

In this qualitative study, four main themes and 12 sub themes were obtained. The main topics were: 1. Financial incentives for physicians (including: motivation for attracting more patients, earning more money, health insurance organizations' liabilities, community expectations of physicians' financial position, physician financial problems, and shifting physician's role from factor to performer), 2. Financial incentives for pharmacies (including: pharmacies' economic problems, health insurance organizations' liabilities, earning more money through over-the-counter sales of all medications, patient insistence and pharmacists' security), 3. Financial incentives for patients (including: self-medication and community poverty) and 4. Financial incentives for pharmaceutical companies (including: earning more profit by selling a particular brand).

Financial motivators are among the important intervening factors in irrational use and prescribing of medications. Providing appropriate financial solutions by policy makers and improving economic situation of the community can help the quality of medical services and improve status of prescribing and usage of medications.

 Today, social determinants of health are defined as one of the most important approaches in examining health differences among communities as well as within them. In this approach, Early Childhood Development has been a centeral theme in the comprehensive evolution of the child. This study endeavored to examine the content analysis of the Medical Sciences’ curriculum from the perspective of Early Childhood Development.

 In view of that, in this qualitative study through content analysis approach based on the pattern of the social factors affecting health, the content of the undergraduate, postgraduate, and doctoral degree programs in Medical University of Isfahan Sciences were analyzed After several stages of screening 27 medical sciences official curriculum were analyzed using MAXQDA.

 The results of content analysis showed that in undergraduate and postgraduate, most of the topics related to Early Childhood Development were from Midwifery and Pediatric Nursing, respectively; that is to say courses containing the concept of Early Childhood Development were related to Bachelor of Midwifery, Bachelor of Public Health, and Master of Pediatric Nursing, respectively.

 Comparing three undergraduate, postgraduate and doctoral degrees, most of the Early Childhood Developmental topics belong to undergraduate degree. The purpose of medical education is gaining knowledge, skills, and information necessary for care and promoting the health of the community, Medical students' didactic content needs to be socially oriented. In the course headings, the social determinants of health and in particular the topics related to the evolution of early childhood need to be highlighted.

Burn gives rise the high mortality and socio-economic burdens. This study aimed to assesses epidemiological characteristics of burn patients and their relationship with mortality caused by burn. This descriptive-analytic study was performed using data from all burned patients hospitalized in Imam Musa Kazem Hospital in Isfahan during 4 years. The data used for the burn patients records and the HIS system were collected, prepared and secondary analyzed in two descriptive and inferential analyses. Of the 3,290 burn patients, 49.22% were died. The highest number of burns were occurred in 2014 (27.08%), in the men (67.29%); age group of 26-40 years old (33.59%); married (49.91%); illiterate (30.42%); low income (48.63%); unemployed (34.66%) and Shia (98.24%) patients. Moreover, the most of patients come from cities from the other provinces (42.1%), lived in urban areas (54.59%), have had social security insurance (41.52%); burn degree 3 (98.33%); total body surface area burned (TBSA) ≤ 30% (49.76%) and burnt at home (70.09%). The correlation of all variables with mortality caused by burn were statistically significant except for years of admission and religion. The burning and the mortality caused by burn, in addition to healthcare and medicine aspects, is a social phenomenon. Therefore, the recognition of social factors as the causes of the causes of burns can leads to the appropriate and effective policies aimed to reduce burns and related mortalities.

IntroductionSince students' academic performance holds significant information which provides feedback to teachers, educational planners, and students, identification of effective variables on academic performance is considered a significant priority. Therefore, this study was designed to investigate the relationship between academic performance of students in medical university of Isfahan with demographic, scholastic and statistics knowledge factors. This is a cross-sectional study with all the students from Isfahan University of Medical Sciences participating, during 2011- 2014. To answer the research questions, necessary information about the participants was taken from computing services office, and then analyzed using SPSS program version 24, through tables, central and dispersion indices, independent t-test, ANOVA, and ANCOVA. Research findings shows that there exist a statistically significant relation between academic performance of students with the variables including sex, age, marital status and statistics knowledge. However, place of accommodation and educational grade were not correlated with academic performance. Considering the significant role of statistics for medical fields and its relevance with academic performance, it is a essential to improve statistics teaching methods. Better academic performance is expected from the students this way.
Citation: Keyvanara M, Hosseini SM, Naderi B. Investigation of the Relationship between Academic Performance of Students at Isfahan University of Medical Sciences with Demographic Academic and Statistics Education. Journal of Development Strategies in Medical Education 2018; 5(2): 13-21

The personnel's of the operating room due to many contacts with patients are exposed to stress, which ultimately leads to burnout. The aim of this study is determining the extent of burnout in the operating room staff in teaching hospitals affiliated medical university of Isfahan in 2016 The present study is a descriptive-analytic study in Isfahan in 2016. The sample of study was 206 employees of operating room staff in Alzahra, Feyz, Kashani, Khorshid and Amin hospitals that they selected by simple method. Data was collected by “Demographic Data” and “Maslach Burnout Inventory” (MBI) questionnaires. Maslach questionnaire has three dimensions: Emotional exhaustion, depersonalization and personal accomplishment. Data was analyzed using SPSS software/23 and descriptive statistics and inferential statistics such as Anova , T-test and Multiple Linear Regression. The mean score of emotional exhaustion was (23.16±11.18), depersonalization (6.39±8.30) and the personality depersonalization respectively (63.27±13.86). There was a significant relationship between demographic variables and job burnout variable and its dimensions. There was no significant relationship between job burnout, emotional exhaustion and Personal accomplishment with demographic variables. But, there was a significant relationship between Depersonalization and demographic variables. The highest predictive for depersonalization was observed with education (MSC). Burnout affects the efficiency and performance of staffs in the operating room. Therefore, managers must provide programs to reduce the level of burnout for providing quality services and reduce costs.

Perhaps the most important challenge in provision of health services is the issue of tariffs. The roles of the Ministry of Health, Treatment, and Medical Education, the Supreme Council of public health services insurance, Ministry of Cooperatives, Labor, and Social Affairs, as well as the Medical Council are specified in law. But it is faced with serious problems in implementation. The purpose of this study was to identify and introduce infrastructures and necessary actions parallel with reforms of medical service tariffs to improve health system performance in Iran.
Purposeful sampling was used and continued until data saturation in this qualitative study. Participants included 12 Health Managers of Tehran, Isfahan, and Tabriz, who were selected based on the study goals. These people were investigated with deep interview. Data analysis was based on a thematic analysis. Criteria such as "credibility", "reliability", "validity", and "stability" of data were considered.
Findings showed that the infrastructure and reforms, according to participant's viewpoints were divided into 3 parts: first, the reform of the Ministry of Health, including structural reforms, reforms related to the provider, and establishment of correct informing; second, health insurance reforms, consisting of structural reforms and actions that should be taken by the government about the insurance; and third, the necessary reforms by the government.
First, it seems that various issues and aspects related to tariff determination should be considered. Furthermore, some preliminaries should be provided before tariff's reformation or some actions should be taken in line with that for the success of tariff reformation process. These measures and reformations are related to the Ministry of Health, insurances, and the government.

Factors affecting blood donation play an important role in attracting safe and continuous blood donors. The current study aimed at determining the factors affecting blood donation through comparing 2 groups of continuous and non-continuous blood donors, using the theory of planned behavior.
The current descriptive, analytical study was carried out in 2015 in Ilam, Iran. The population contained 234 blood donors recruited by the quota sampling method. The data were collected by the theory of planned behavior questionnaire (TPB questionnaire) developed by Hasanzade et al., which its validity and reliability were evaluated and confirmed in previous studies. Data were analyzed with SPSS version 16, using the Spearman correlation and the Mann-Whitney U tests.
Among continuous and non-continuous blood donors, 54.4% and 50.8% had higher education, 35.1% and 45.8% had job, 99.3% and 88.3% were male, 80.7% and 75.8% were married, and 66.8% and 61.7% were in the age range of 30 - 50 years, respectively. Results also indicated that attitudes (score = 0.28), facilitating factors (score = 0.28), and self-efficacy (score = 0.27) were the most important factors affecting blood donation in the continuous donors group, while attitudes (score = 0.27) and facilitating factors (score = 0.20) were the most important ones in the non-continuous blood donors.
In the current study, attitudes and facilitating factors were the predictive factors of donation behavior. It is proposed to design intervention programs and launch educational campaigns to attract long-term donors in order to improve the attitudes toward blood donation and encourage and attract donors to increase and retain both the continuous and non-continuous donors.

Self-immolation is among the most damaging types of injuries from burns, causes serious physical injuries and has psychological and economic effects on the person and his or her family. This study assessed the epidemiological characteristics of patients hospitalized in Imam Musa Kazim hospital, Isfahan, Iran, due to self-immolation during a 5-years period.
In this retrospective cross-sectional study, all records of the patients hospitalized due to self-immolation during the years 2010-2014 were assessed. Then, information such as age, sex, marital status, employment, etc. was extracted by using a researcher-made checklist. The data were analyzed using SPSS software in both descriptive and analytic aspects.
Findings: Out of 450 participants, who had self-immolation during the studied 5 years, 373 patients (82.9%) were women and 77 patients (17.1%) were men. 366 patients (74.7%) were married and 114 (25.3%) were single. Most of the studied patients (68.4%) were in the age category of 20-39 years old. 74.0 percent of the patients were housewives. Self-immolation was more prevalent in spring than in other seasons. About half of the patients (49.1%) died of self-immolation. The hospitalization duration of 10 to 15 days and the burning level of 31 to 70 percent (32.2% and 47.5%, respectively) were more prevalent.
According to the results of this study and most of the similar studies, housewife married women in the age category of 20-29 years, are subject to eliminate their lives via self-immolation more than any other people.

Setting tariffs is one of the most important tools of policy makers at Health system in every country for applying stewardship which is effective on justice, effectiveness, quality and accountability of health services, and also could influence the accessibility and the rate of using health care services. The changing of medical tariffs not only could affect the income of medical and hospital service providers, but also could affect the costs of the funders of medical and hospital services. This study was conducted to investigate the concept of real tariff from insurance organizations managers’ point of view.
This qualitative study was conducted using in-depth interview with 19 informed managers, or relevant managers of insurance organizations, social security and armed forces. Data was analysed thematic analysis method.
In general four main challenges were reported by participants as the challenges of tariffs including: methods, structure and principles of tariff setting; economic aspects, dissatisfaction of professionals involved with tariff setting, and lack of supervision on non-tariff expressed, and implementation challenges.
The identified challenges should be taken into account to modify the tariff setting, and to identify problems. The practical principles should be considered to determine tariffs as well as the scientific and logical principles.

Intrudaction: Medical services pricing is one of the most important tools of each country's health system policy makers. Tariff is effective on equity, efficiency, quality and accountability in the provision of services and it can affect the availability and use of services. Switch medical services tariffs affected providers of hospital and medical services income on the one hand, and on the other hand the cost of medical and hospital care providers of financial resources. This study aims to predict the consequences of the reform of pricing medical services (making medical services tariffs) were performed.
This study is a qualitative study. Sampling was Purposeful and continued until data saturation. Research Society was 12 people of, Health Managers of cities include Tehran, Isfahan and Tabriz, that in the purpose of the study, these people were investigated with deep interview. Analysis of the data in this study is based on a thematic analysis. Criteria such as "reliable information", "trustworthy", "reliability" and "ability to consolidation" of data were considered.
According to findings, the results of the study were divided into two categories: positive and negative consequences as a result of medical services tariff reforms and likely increase, although logically and scientifically. The positive consequences include behavioral outcomes, economic and stakeholder satisfaction. And negative consequences include economic consequences and limited group dissatisfaction.
The consequences have been anticipated at the time of modification of medical tariffs in addition to encouraging health tariff and policy makers Because of the benefits that will be earned in terms of positive consequences, they noticed negative consequences, particularly in economic consequences and the need to provide for an increase in tariffs and the need to think for provides financing compensatory.

During the past 10 years, drug budget have grown enormously from 500 million Dollars to 3 billion Dollars in Iran. Irrational drug prescription can cause additional costs on people/government and can waste the resources. Designing and implementing appropriate interventions to control drug prescription and usage can be effective in controlling the issue. This study was carried out to presenta framework for the most important reasons of the WHO's 12 strategies about irrational use and drug prescription.
In this review article, we have searched the Google, Google scholar, SID, Magiran, Irandoc, and the PubMed with the following keywords: WHO's Strategies, rational prescribing, rational drug use, and rational use of medicine. A total of 70 related articles published in the two last decades were retrieved. After excluding the unrelated articles, data of 43 articles were extracted and analyzed.
According to this study, WHO's 12 strategies were classified in four educational, managerial, regulatory, and financial dimensions. Most studies had been focused on the educational and managerial strategies that seemed to be the most important reasons of irrational drug prescription.
The results of this study provided information on the WHO's strategies in different countries. The results can be used by the policymakers to consider different dimensions of rational use and prescription of drugs in planning appropriate programs.

Tariff is effective on equity, efficiency, quality and accountability in the provision of services and it can affect the availability and use of services. In our country, for several years, the tariff of health care is due to an increasing base and has not clear and defensible base. This matter creates different challenges in our health system. This study aimed to identify challenges and damages resulting from incorrect medical services. This study was a qualitative study. Sampling was Purposeful and continued until data saturation was obtained. Research Society were 12 people of Health Managers of cities including Tehran, Isfahan and Tabriz, that in the purpose of the study, these people were investigated with deep interview. Analysis of the data in the present study was based on a thematic analysis. Criteria such as "reliable information", "trustworthy", "reliability" and "ability tocon solidation" of data were considered. according to the findings, inefficiency of tariffs for medical services have caused challenges in the current situation that this damages were divided to three general categories and challenges, dissatisfaction, economic, and behavioral of Ministry of Health, doctors, patients and insurers. Dissatisfaction with stakeholders, especially health providers, the first factor is that a real so following other challenges including; economic and behavioral challenges. Challenges of incorrect tariffs and their Bad effects on the health system stakeholders are a warning to administrators and policy makers of this system, finding causes and attempting to fix the challenges. Although incorrect medical tariff is introduced as one of the challenges causes, but it is necessary in addition to that are note other structural and Rooty problems in the health system, as noted tariff reforms to fully be able to solve the created challenges.

Setting tariffs is one of the most important tools of policy makers of the health system in every country for implementing their authority which is effective in justice, performance, and the quality of and accountability in offering services. Moreover, it can influence access rate and use of services. Changing medical tariffs affects the income of medical and hospital service providers, and the expenditure of financiers of medical and hospital services. This study investigated the concept of real tariff from the point of view of managers of insurance organizations. This qualitative study was performed via in-depth interviews with 19 managers of health, social security, and armed forces insurance organizations who were informed of or their occupation was related to this field. Thematic analysis method was used for analyzing interviews. Managers of insurance organizations expressed the concept of real tariff in two themes of definition of real tariff, and methods, elements, and principles of determining tariffs and subthemes of determination of tariffs based on collective agreement considering interests of involved groups, based on cost of services, and based on type and sensitivity. To amend the status of setting tariffs, characteristics of real tariff should be identified based on the concept of real tariff. Interests of involved groups (insured, service provider, and insurer) should be considered in determining tariffs. Tariffs should be determined based on collective agreement, the views of representatives of involved groups, and cost of services.