Introduction: The health system reform plan was carried out in university hospitals with eight practical plans in the second half of June 2014. One of these plans is the decrease in the payment made by inpatients. The present research has been conducted aiming at studying the effect of the design of changing health system pays of insurance by people.

Materials & methods: The present study is analyzing- descriptive and field studies that were done in 2013-2014 in quantitative and cross sectional way.  The statistical population of this research consists of 2178 people under the insurance of health care organization of Iran that were hospitalized in the hospitals of Ilam of whom 937 belong to 2013 and 1205 belong to 2014. Out of these patients, 331 subjects have been selected by Morgan table as the research sample. In the present study the librarian method and theoretical bases were used to collect athering data and statistical findings have been selected by field method. The bases of collecting findings were statistics and documents of costs of inpatients that were analyzed by Excel and SPSS22 software in two parts of descriptive and inferential statistics.

Findings: The findings show that the mean of total of costs of each inpatient in 2014 had growth compared to 2013 in 44 percent. Final share of pay of people in 2014 compared to 2013 in women and delivery part had decreased in 11.2 percent and reached 26 percent and other parts with 10.6 percent decreasing, it reached 4.6 percent that the share of rural insurance was more than other ones. During the design of changing health system, governmental subsidies covered 6.1 of hospital costs and mean of base cost of insurance with growth of 5.9 percent was 86 percent.

Discussion & conclusions: According to the results of the present study, the variables of the health system reform plan, the subsidies paid by the govermment to the health care system as well as having an agraring certificate lead to a decrase in payment made by the patients. Nevertheless the implementation of the health system reform plan has had the general effects of an increase in the expenses.