Paper Information

Journal:   ARCHIVES OF IRANIAN MEDICINE   JULY 2014 , Volume 17 , Number 7; Page(s) 507 To 513.
 
Paper: 

HOSPITALIZATION AND CATASTROPHIC MEDICAL PAYMENT: EVIDENCE FROM HOSPITALS LOCATED IN TEHRAN

 
DOI: 

0141707/AIM.0012

 
Author(s):  GHIASVAND HESAM, SHABANINEJAD HOSSEIN, ARAB MOHAMMAD, RASHIDIAN ARASH*
 
* DEPARTMENT OF HEALTH MANAGEMENT AND ECONOMICS, SCHOOL OF PUBLIC HEALTH & KNOWLEDGE UTILIZATION RESEARCH CENTER, TEHRAN UNIVERSITY OF MEDICAL SCIENCES, POURSINA ST., KESHAVARZ BLVD., TEHRAN, IRAN
 
Abstract: 

INTRODUCTION: Hospitalized patients constitute the main fraction of users in any health system. Financial burden of reimbursement for received services and cares by these users is sometimes unbearable and may lead to catastrophic medical payments. So, designing and implementing effective health prepayments schemes appear to be an effective governmental intervention to reduce catastrophic medical payments and protect households against it. We aimed to calculate the proportion of hospitalized patients exposed to catastrophic medical payments, its determinant factors and its distribution.
MATHERIALS AND METHODS: We conducted a cross sectional study with 400 samples in five hospitals affiliated with Tehran University of Medical Sciences (TUMS). A self-administered questionnaire was distributed among respondents. Data were analyzed by logistic regression and ?2 statistics. Also, we drew the Lorenz curve and calculated the Gini coefficient in order to present the distribution of catastrophic medical payments burden on different income levels.
RESULTS: About 15.05% of patients were exposed to catastrophic medical payments. Also, we found that the educational level of the patient’s family head, the sex of the patient’s family head, hospitalization day numbers, having made any out of hospital payments linked with the same admission and households annual income levels; were linked with a higher likelihood of exposure to catastrophic medical payments. Also, the Gini coefficient is about 0.8 for catastrophic medical payments distribution.
CONCLUSION: There is a high level of catastrophic medical payments in hospitalized patients. The weakness of economic status of households and the not well designed prepayments schemes on the other hand may lead to this. This paper illustrated a clear picture for catastrophic medical payments at hospital level and suggests applicable notes to Iranian health policymakers and planners.

 
Keyword(s): CATASTROPHIC MEDICAL PAYMENTS, GINI COEFFICIENT, HOSPITALIZED PATIENTS, OUT, OF, POCKET PAYMENTS, PREPAYMENT SCHEMES
 
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