Table 2.

Exploring the challenges in the financial transaction between CNCSCs and their clients

Main Category	Subcategory	Initial Code
A:Theflaunted atmosphere due to direct financial transaction	A1. Direct unfavorable monetary exchanges	The financial pressure on clients caused by their direct payment of the costs incurred by services
		Problems in the reimbursement of the costs due to the lack of public insurance coverage
		The reluctance and inability to direct out of pocket payment for health-related expenses
	A2. The complex interaction with private insurance companies	The low acceptance of CNCSCs and the independent rule-setting by some private insurance companies
		The complex documentation needed for the reimbursement of costs by complementary insurance
		The incomplete reimbursement of costs by private insurance companies
B:Instability in determining tariffs for nursing services	B1.Inadequate attention to CNCSC services	The ambiguity and undefined roles of CNCSCs in price-setting
		Delay in updating Irrational and outdated prices
	B2.The need to bargain with the CNCSCs and clients to fix a price	Bilateral (CNCSC-client) efforts for financial profiting
		Clients being uncertain about the price of nursing services offered at CNCSCs
	B3. A defective environment of competence	Independent nursing home care by nurses and clinics
		Easier access to inexpensive, although unprofessional and low-quality, home care services
		The client’s preference for receiving services from hospitals and governmental health care centers given their comparatively lower prices
C: The use of benefit strategies for cost-effective services and client satisfaction	C1. Regulating financial transactions with the families	Financial transactions limited to only one of the family members
		Avoiding a direct financial transaction between the CNCSCs staffs and the family members
	C2. Expediency trying to expand organizational relationships	A cautious work relationship with some semi-private organizations
		Trying to expand professional relationships with rich and financially-independent organizations
		Trying to expand the delivery of services to clients with complementary insurance coverage
	C3.Trying to rationalize the costs of service for the clients	Informing the clients about the sensitivity and benefit of community-based nursing services
		Assisting the clients in preparing adequate documentation for the reimbursement of costs by complementary insurance