The Risk of Catastrophic Health Expenditures Due to Direct Non-Medical Costs in Patients: A Study of the Outpatients in Qazvin, Iran

Background: Out-of-pocket payment encompasses the costs that patients pay for healthcare services, which is an inefficient approach to healthcare financing as it may lead to poverty. Objectives: The present study aimed to determine the risk of catastrophic health expenditures due to non-medical costs in the outpatients in Qazvin, Iran. Methods: This cross-sectional survey was conducted on ۳۴۱ outpatients referring to the internists of Velayat Hospital and Bu-Ali Sina Hospital in Qazvin. The required data were collected using a researcher-made questionnaire and the prescriptions of the patients. Out-of-pocket payments were defined as the direct medical and non-medical costs within one month. Results: The mean out-of-pocket payments of the patients in one month was ۴۹.۹۷ dollars, ۷۵.۸% of which covered direct medical cost (disease diagnosis and treatment), and ۲۴.۲% covered direct non-medical costs to receive health services. The highest out-ofpocket payments were for diagnostic/laboratory tests (۵۰.۳%), medications (۲۱.۵%), and transportation (۱۸.۲%). In addition, the exposure rate to catastrophic expenditures was estimated at ۳۱%, and the patients with lower income had less exposure compared to those without incomes. Conclusions: According to the results, direct non-medical costs were associated with the increased out-of-pocket payments of the patients, which in turn led to the higher rates of catastrophic expenditures.

Keywords:

Direct Non-medical Costs , Out-of-pocket Payment , Catastrophic Health Expenditures , Outpatients , Iran