Mohammadi Ali, Lotfi Farhad, Ravangard Ramin, Emadi Mehrnoosh, Bayati Mohsen
Student Research Committee, School of Health Management and Information Sciences Shiraz University of Medical Sciences Shiraz Iran.
School of Health Management and Information Sciences, Health Human Resources Research Center Shiraz University of Medical Sciences Shiraz Iran.
Health Sci Rep. 2023 Apr 17;6(4):e1230. doi: 10.1002/hsr2.1230. eCollection 2023 Apr.
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.
The study population consisted of all Iran Health Insurance Organization insurees in Fars province in 2019 ( = 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.
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 ( < 0.05).
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.
分析卫生服务的利用情况对于资源分配和卫生服务提供规划至关重要。本研究旨在调查2019年法尔斯省伊朗健康保险组织参保者的门诊服务利用情况、成本及其影响因素。
研究人群为2019年法尔斯省所有伊朗健康保险组织参保者（n = 2,618,973）。服务利用和成本数据从法尔斯健康保险组织的信息系统中提取。按性别、年龄和保险基金类型提供门诊服务利用和成本的描述性统计数据。还使用单因素分析和横断面回归研究不同因素对各类服务利用和成本的影响。数据分析也使用了EXCEL和STATA 15软件。
实验室、药品和放射科服务的年平均利用率分别为0.940、0.945和0.108次处方。此外，实验室、药品和放射科服务的年平均成本分别为1.13美元、7.44美元和2.26美元。单因素和多因素分析表明，性别、保险基金类型和年龄对实验室、药品和放射科服务的利用和成本有显著影响（P < 0.05）。
老年人和女性的门诊服务利用和支出较高。为控制保险组织的成本，识别有效因素很有帮助。此外，由于伊朗老龄化趋势加剧，似乎有必要定期监测老年人卫生服务利用模式，并规划在未来几年增加保险融资的可持续资源。
