Utilization and cost of outpatient services: A cross‐sectional study on the Iran Health Insurance Organization insurees in Fars province
Abstract Background and Aims Analyzing the utilization of health services is necessary for allocating the resources and planning the provision of health services. The present study aimed at investigating the utilization and cost of outpatient services and the factors affecting it among the insurees...
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Format: | Article |
Language: | English |
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Wiley
2023-04-01
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Series: | Health Science Reports |
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Online Access: | https://doi.org/10.1002/hsr2.1230 |
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author | Ali Mohammadi Farhad Lotfi Ramin Ravangard Mehrnoosh Emadi Mohsen Bayati |
author_facet | Ali Mohammadi Farhad Lotfi Ramin Ravangard Mehrnoosh Emadi Mohsen Bayati |
author_sort | Ali Mohammadi |
collection | DOAJ |
description | Abstract Background and Aims Analyzing the utilization of health services is necessary for allocating the resources and planning the provision of health services. The present study aimed at investigating the utilization and cost of outpatient services and the factors affecting it among the insurees of the Iran Health Insurance Organization in Fars province in 2019. Methods The study population consisted of all Iran Health Insurance Organization insurees in Fars province in 2019 (n = 2,618,973). The data on the utilization and cost of the services were extracted from the information systems of Fars Health Insurance Organization. The descriptive statistics of the utilization and cost of outpatient services were provided by gender, age, and type of insurance fund. The effects of different factors on the utilization and cost of various services were also investigated using univariate analysis as well as cross‐sectional regression. The data analysis was done using EXCEL and STATA 15 software as well. Results The average utilization rates of laboratory, drug, and radiology services were 0.940, 0.945, and 0.108 prescriptions per year, respectively. In addition, the mean costs of laboratory, drug, and radiology services were $1.13, $7.44, and $2.26 per year, respectively. The univariate and multivariate analyses showed that gender, type of insurance fund, and age had significant effects on the utilization and costs of laboratory, drug, and radiology services (p < 0.05). Conclusion The utilization and expenditure of outpatient services were higher among the elderly and women. To control the costs of insurance organizations, it is helpful to identify the effective factors. In addition, due to the increasing trend of aging in Iran, it seems necessary to periodically monitor the pattern of the elderly people's utilization of health services and to plan to increase sustainable resources for insurance financing in the coming years. |
first_indexed | 2024-04-09T16:02:45Z |
format | Article |
id | doaj.art-4893f11fea7f42bf86fe985a39b14c59 |
institution | Directory Open Access Journal |
issn | 2398-8835 |
language | English |
last_indexed | 2024-04-09T16:02:45Z |
publishDate | 2023-04-01 |
publisher | Wiley |
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series | Health Science Reports |
spelling | doaj.art-4893f11fea7f42bf86fe985a39b14c592023-04-25T08:04:33ZengWileyHealth Science Reports2398-88352023-04-0164n/an/a10.1002/hsr2.1230Utilization and cost of outpatient services: A cross‐sectional study on the Iran Health Insurance Organization insurees in Fars provinceAli Mohammadi0Farhad Lotfi1Ramin Ravangard2Mehrnoosh Emadi3Mohsen Bayati4Student Research Committee, School of Health Management and Information Sciences Shiraz University of Medical Sciences Shiraz IranSchool of Health Management and Information Sciences, Health Human Resources Research Center Shiraz University of Medical Sciences Shiraz IranSchool of Health Management and Information Sciences, Health Human Resources Research Center Shiraz University of Medical Sciences Shiraz IranSchool of Health Management and Information Sciences, Health Human Resources Research Center Shiraz University of Medical Sciences Shiraz IranSchool of Health Management and Information Sciences, Health Human Resources Research Center Shiraz University of Medical Sciences Shiraz IranAbstract Background and Aims Analyzing the utilization of health services is necessary for allocating the resources and planning the provision of health services. The present study aimed at investigating the utilization and cost of outpatient services and the factors affecting it among the insurees of the Iran Health Insurance Organization in Fars province in 2019. Methods The study population consisted of all Iran Health Insurance Organization insurees in Fars province in 2019 (n = 2,618,973). The data on the utilization and cost of the services were extracted from the information systems of Fars Health Insurance Organization. The descriptive statistics of the utilization and cost of outpatient services were provided by gender, age, and type of insurance fund. The effects of different factors on the utilization and cost of various services were also investigated using univariate analysis as well as cross‐sectional regression. The data analysis was done using EXCEL and STATA 15 software as well. Results The average utilization rates of laboratory, drug, and radiology services were 0.940, 0.945, and 0.108 prescriptions per year, respectively. In addition, the mean costs of laboratory, drug, and radiology services were $1.13, $7.44, and $2.26 per year, respectively. The univariate and multivariate analyses showed that gender, type of insurance fund, and age had significant effects on the utilization and costs of laboratory, drug, and radiology services (p < 0.05). Conclusion The utilization and expenditure of outpatient services were higher among the elderly and women. To control the costs of insurance organizations, it is helpful to identify the effective factors. In addition, due to the increasing trend of aging in Iran, it seems necessary to periodically monitor the pattern of the elderly people's utilization of health services and to plan to increase sustainable resources for insurance financing in the coming years.https://doi.org/10.1002/hsr2.1230drug utilizationhealth care costshealth servicesinsurance |
spellingShingle | Ali Mohammadi Farhad Lotfi Ramin Ravangard Mehrnoosh Emadi Mohsen Bayati Utilization and cost of outpatient services: A cross‐sectional study on the Iran Health Insurance Organization insurees in Fars province Health Science Reports drug utilization health care costs health services insurance |
title | Utilization and cost of outpatient services: A cross‐sectional study on the Iran Health Insurance Organization insurees in Fars province |
title_full | Utilization and cost of outpatient services: A cross‐sectional study on the Iran Health Insurance Organization insurees in Fars province |
title_fullStr | Utilization and cost of outpatient services: A cross‐sectional study on the Iran Health Insurance Organization insurees in Fars province |
title_full_unstemmed | Utilization and cost of outpatient services: A cross‐sectional study on the Iran Health Insurance Organization insurees in Fars province |
title_short | Utilization and cost of outpatient services: A cross‐sectional study on the Iran Health Insurance Organization insurees in Fars province |
title_sort | utilization and cost of outpatient services a cross sectional study on the iran health insurance organization insurees in fars province |
topic | drug utilization health care costs health services insurance |
url | https://doi.org/10.1002/hsr2.1230 |
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