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

 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.

 The present study aimed to determine the risk of catastrophic health expenditures due to non-medical costs in the outpatients in Qazvin, Iran.

 This cross-sectional survey was conducted on 341 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.

 The mean out-of-pocket payments of the patients in one month was 49.97 dollars, 75.8% of which covered direct medical cost (disease diagnosis and treatment), and 24.2% covered direct non-medical costs to receive health services. The highest out-of-pocket payments were for diagnostic/laboratory tests (50.3%), medications (21.5%), and transportation (18.2%). In addition, the exposure rate to catastrophic expenditures was estimated at 31%, and the patients with lower income had less exposure compared to those without incomes.

 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.