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Estimating out-of-pocket costs for outpatient diagnostic services in Qazvin teaching hospitals in 2013

Number of pages: 72 File Format: word File Code: 31967
Year: 2013 University Degree: Master's degree Category: Health - Health
Tags/Keywords: Backbreaking payments - birth of poverty - Costs of direct payments - Diagnostic services - Diagnostic services - health system - hospital - Impoverishment - Pay out of pocket - Social welfare
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  • Summary of Estimating out-of-pocket costs for outpatient diagnostic services in Qazvin teaching hospitals in 2013

    Dissertation for obtaining a master's degree in healthcare management

    Abstract:

    Introduction and purpose: Direct out-of-pocket payments are one of the sources of financing in the health system, which today has faced many families with back-breaking health costs. The purpose of this study is to estimate the out-of-pocket costs of diagnostic outpatient services in the hospital. Methodology: The current descriptive-analytical study was conducted on 630 people who referred to outpatient diagnostic services in 2013 using structured interviews and document review. Also, the interview data collection tool included 5 variables: age, sex, type of insurance, out-of-pocket payment, and contribution from the patient's insurance organization. The percentage of out-of-pocket costs was obtained by dividing the out-of-pocket costs by the total costs (out-of-pocket payments + insurance organization) to the service provider. The analysis of the collected data was done using descriptive and analytical statistics. Pearson and t correlation tests were used to investigate the relationship with age and gender.

    Findings: 74% of the clients had insurance coverage or had the conditions to use insurance. The most used insurance with 45% was related to social security. The lowest average age of clients to the diagnostic services of Quds Hospital was 7 years for laboratory services and 12 years for imaging services. The percentage of direct out-of-pocket costs of laboratory patients was 48%, 47%, 44%, and 41% in Shahid Rajaei, Bou Ali Sina, Quds, and Kausar hospitals, respectively, and in the imaging department of these hospitals, it was 48%, 44%, 39%, and 46%, respectively. There was no relationship between age and gender with out-of-pocket payments.

    Discussion and conclusion: reducing direct payments by increasing the coverage and depth of insurance, as well as more support in the expensive CT scan service, will improve people's health and justice.  

    Key words: out-of-pocket payment, diagnostic services, health system, hospital

    Introduction:

    Health is known as one of the main preconditions of social welfare systems. In addition to having a healthy lifestyle, people are forced to use health services and in other words buy those services in order to improve and restore their health in case of illness. According to the type of health system, the use of these services imposes different financial pressures on people in different societies. These costs, which are paid directly out of pocket, have caused financial problems for households and may trap them in poverty (Moray et al. 2003).

    Diagnostic services are a vital element for providing the best care measures for patients, and these services provide necessary information for doctors to evaluate and diagnose the patient's conditions and appropriate treatment measures, as well as timely diagnostic services, which are a fundamental part of health care, provide effective treatment and meaningful improvement of patients, and provide information about the presence or absence of disease (Yu 2007). Today, the lack of financial protection in health is known as a disease of health systems; The clearest sign of this is that households suffer not only from the burden of disease, but also from the burden of economic poverty and facing catastrophic expenditure and the poverty of financing their health (Knavel et al. 2006). Problem Statement: High out-of-pocket expenses can result from essential household purchases such as food and Prevent clothing. Every year, approximately 44 million households and more than 150 million people are faced with back-breaking health costs, and approximately 25 million households and more than 100 million people are driven to poverty. Also, a large number of people may decide not to use simple medical and laboratory services due to the lack of financial ability, or to abandon these services due to indirect costs such as transportation and nutrition (Zou et al., 2005).Out-of-pocket payments are the main financing mechanism in most Asian and other developing countries (Liu et al. 2008).

    In most countries, the costs of direct out-of-pocket payments are so high that households are unable to finance them and fall into poverty (Sun et al. 2009, Fan et al. 2004). Studies have shown that the poor are extremely vulnerable when they need essential health services to meet these needs (Peters 2002, Paradehan et al. 2002). When a system relies on direct out-of-pocket payments to meet people's health needs, this can involve back-breaking payments for individuals (Zu et al. 2003).

    Although high-income households and the wealthy spend more on health, they are less likely to experience impoverishment due to these costs (India 2010). There are a large number of studies that show the distribution of direct out-of-pocket payments and their effect on household poverty and well-being (Knavel et al. 2005, Van Doslar et al. 2006). Out-of-pocket costs are typically a downward-sloping tool in health financing and put the greatest pressure on the poor (Whitehead et al. 2001). Also, a number of studies have shown that back-breaking costs are higher in some groups, data shows that 2 groups of people over 60 years of age and children under 5 years of age are more exposed to these costs (Su et al. 2006, Zhu et al. 2006). The demand for health services is unpredictable, therefore, out-of-pocket expenses can have a destructive effect on household expenses and ultimately the formation of family poverty. Appropriate financing and better risk pooling mechanisms are introduced as the most important mechanism to reduce the share of direct out-of-pocket payments of the household and also to reduce the effects of back-breaking health costs on the household (Zu et al. 2003).

    Gradlis, in the study of the equality of socio-economic indicators related to health in the European Union countries, estimated the share of drug costs from the household income as one of the indicators with the highest Gini coefficient (severe inequality). (Gradlis 2001), which indicates that the cost of medicine exerts severe pressure on low-income households.

    The calculation of direct out-of-pocket payments in Nepal, Hong Kong, the Philippines, Taiwan, Thailand, Sri Lanka, Bangladesh, South Korea and China showed that they provide at least 30% of health financing costs through out-of-pocket payments. (Musgrove et al. 2001). A study in Burkina Faso showed that the key indicators of back-breaking health costs include the economic status, the household's use of modern medical services, the period of illness in the elderly members of the household, and the presence of a person with a chronic disease (So et al., 2006).

    Today, the reforms in the health system directly affect the expenses incurred on the household's health. suffer (Difazio et al. 2011). In a study conducted by Baji in Hungary, the results showed that the people of this country suffer from high out-of-pocket payments for health services, and in this country financing is extremely negative, so that the Kakwani index is negative in this country (Baji et al., 2012). Low income people are more likely to face back-breaking health costs (Asefzadeh et al. 2013).

  • Contents & References of Estimating out-of-pocket costs for outpatient diagnostic services in Qazvin teaching hospitals in 2013

    List:

    Introduction..7

    1-2 Statement of the problem..7

    1-3 Objectives and assumptions.11

    Main objective..11

    Sub-objectives..11

    Applicable objective..11

    Research questions..12

    Chapter two:

    1-2-theoretical bases of research.13

    2-2 Review of studies.32

    Third chapter:

    Introduction..38

    Fourth chapter:

    Introduction..43

    Fifth chapter:

    Discussion and conclusion.59

    Appendix.74

     

    Source:

    Alu?sio J. D. Barros (2011), Catastrophic spending on health care in Brazil: private health insurance does not seem to be the solution, Cad. Sa?de P?blica, Rio de Janeiro54-62

    Arunachalam M, Lawrence S, Kelly M, Locke J(2012). A Communitarian Approach to Constructing Accountability and Strategies for Sustainable Development. Issues in Social and Environmental Accounting. 1(2):217-42.

    Asefzadeh S, Alijanzadeh M, Gholamalipoor S, Farzaneh A (2013). Households Encountering with Catastrophic Health Expenditures in Qazvin, Iran. Health Information Management. 10(1): 1-8.

    Ayé R, Wyss K, Abdualimova H, Saidaliev S (2010). Illness costs to households are a key barrier to access diagnostic and treatment services for tuberculosis in Tajikistan. BMC Research Notes. 3(1): 340.

    Baji P, Pavlova M, Gul?csi L (2012). Changes in Equity in Out-of-pocket Payments during the Period of Health Care Reforms: Evidence from Hungary. International journal for equity in health. 11(1): 1-11.

    Bennett KJ, Dismuke CE (2010). Families at financial risk due to high ratio of out-of-pocket health care expenditures to total income. Journal Health Care Poor Underserved. 21:691-703

    Chaudhuri A, Roy K (2008). Changes in out-of-pocket payments for healthcare in Vietnam and its impact on equity in payments, 1992-2002. Health policy journal. 88(1): 38-48.

    Culyer AAJ, Newhouse JP (2000). Handbook of Health Economics: Vol. 1A: Access Online via Elsevier.

    Damme WV, Leemput LV, Por I, Hardeman W (2004). Out-of-pocket health expenditure and debt in poor households: evidence from Cambodia. Tropical Medicine & International Health. 9(2):273-80.

    DiFazio R, Vessey J (2011). Nonmedical out-of-pocket expenses: a hidden cost of hospitalization. Journal of Pediatric Nursing. 26(1): 78-84.

    Fan JX, Zick CD (2004). The economic burden of health care, funeral, and burial expenses at the end of life. Journal of Consumer Affairs. 38(1): 35-55.

    Frenk J, Gonz?lez-Pier E, G?mez-Dantés O, Lezana MA, et al (2006). Comprehensive reform to improve health system performance in Mexico. The Lancet journal. 368(9546): 1524-34.

    Galarraga O, Sosa-Rubi SG, Salinas A, Sesma S (2008). The impact of universal health insurance on catastrophic and out-of-pocket health expenditures in Mexico: A model with an endogenous treatment variable. Health, Econometrics and Data Group Working Paper 08/12, the University of York.

    Garg CC, Karan AK (2009). Reducing out-of-pocket expenditures to reduce poverty: a disaggregated analysis at rural-urban and state level in India. Health policy and planning. 24(2): 116-28.

    Ghiasvand H, Hadean M, Maliki M, Shabaninejad (2010). Determinants of Catastrophic Medical Payments in Hospitals Affiliated to Iran University of Medical Sciences; 2009. Hakim Research Journal 13(3): 145-154

    Giraldes R (2001). Equity in socioeconomic areas with impact on health in countries of the European Union. Cad Saude Publica journal. 17(3): 533-44

    Gotsadze G, Zoidze A, Rukhadze N (2009). Household catastrophic health expenditure: evidence from Georgia and its policy implications. BMC health services research. 9(1):69-83.

    Hanratty B, Zhang T, Whitehead M (2007). How close have universal health systems come to achieving equity in the use of curative services? A systematic review. International Journal of Health Services. 37(1):89-109.

    India I (2010). TheThe impoverishing effect of healthcare payments in India: new methodology and findings. Economic & Political Weekly. 45(16): 65.

    Knaul FM, Arreola-Ornelas H, Méndez-Carniado O, Bryson-Cahn C, et al (2006). Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico. The Lancet journal. 368(9549): 1828-41

    Knaul FM, Frenk J (2005). Health insurance in Mexico: achieving universal coverage through structural reform. Health affairs journal. 24(6): 1467-76.

    Knaul FM, Arreola-Ornelas H, Méndez O (2005). Financial protection in health: Mexico, 1992 to 2004. Journal of salud p?blica de México. 47(6): 430-9.

    Layte R, Nolan B (2004). Equity in the utilization of health care in Ireland. The Economic and Social Review. 35(2):111-34.

    Leive A, Xu K (2008). Coping with out-of-pocket health payments: empirical evidence from 15 African countries. Bulletin of the World Health Organization. 86(11): 56-849.

    London L (2007). 'Issues of equity are also issues of rights': Lessons from experiences in Southern Africa. BMC Public Health. 7(1):14.

    Measuring catastrophic health care expenditures in Nigeria Implications for financial risk protection, RESEARCH BRIEF MARCH 2010.

    Mediterranean WHO (1997). The Work of WHO in the Eastern Mediterranean Region: Annual Report of the Regional Director: World Health Organization, Regional Office for the Eastern Mediterranean

    Murray CJL, Xu K, Klavus J, Kawabata K, et al (2003). Assessing the distribution of household financial contributions to the health system: concepts and empirical application. Health systems performance assessment Debates, methods and empiricism Geneva: WHO. 513-31.

    Musgrove P, Zeramdini R, Carrin G (2001). summary description of health financing in WHO Member States.  Commission on Macroeconomics and Health working paper No WG3

    Nekoei Moghadam M (2012). Iranian Household Financial Protection against Catastrophic Health Care Expenditures. Iranian Journal of Public Health. 41(9): 62-70.

    O'Donnell O, Van Doorslaer E, Rannan-Eliya RP, Somanathan A, et al (2008). Who pays for health care in Asia? Journal of Health Economics. 27(2): 460-75.

    Peters DH (2002). Better health systems for India's poor: findings, analysis, and options: World Bank Publications.

    Pradhan M, Prescott N (2002). Social risk management options for medical care in Indonesia. Health. 11(5):431-46.

    Rivero CC, Ruiz GAL, Barrera RM, Levet C (2006). Catastrophic expenditure in health and income elasticity's by item of expenditure in health services in Mexico. Well-Being and Social Policy 2(1):47-69.

    Russell S (2004). The economic burden of illness for households in developing countries: a review of studies focusing on malaria, tuberculosis, and human immunodeficiency virus/acquired immunodeficiency syndrome. The American journal of tropical medicine and hygiene. 71(2):147-55.

    Seonae Y (2004). Language barriers and access to care. Annual review of nursing research. 22(1):59-73.

    Sesma-V?zquez S, Perez-Rico R, Sosa-Manzano C, Gomez-Dantes O (2005). Catastrophic health expenditures in Mexico: magnitude, distribution and determinants. Journal of public health in Mexico. (47): 24-37.

    Sonila Tomini and Truman G. Packard (2008). Are health care payments in Albania catastrophic? Evidence from ALSMS.

    Sun X, Jackson S, Carmichael G, Sleigh AC (2009). Catastrophic medical payment and financial protection in rural China: evidence from the New Cooperative Medical Scheme in Shandong Province. Health Economics journal. 18(1): 103-19.

    Su TT, Kouyaté B, Flessa S (2006). Catastrophic household expenditure for health care in a low-income society: a study from Nouna District, Burkina Faso. Bulletin of the World Health Organization. 84(1): 21-7.

    Torres AC, Knaul FM, Funsalud (2003).

Estimating out-of-pocket costs for outpatient diagnostic services in Qazvin teaching hospitals in 2013
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