Pattern of Outpatient Health Service Utilization by Older People in Iran

 Considering the rapid growth of Iran’s elderly population with consequent increase in the costs of health services, it is necessary to be aware of the pattern of outpatient health service utilization, in the elderly for resource allocation and health planning. This study aims to determine the pattern of outpatient service utilization for the elderly in Iran and explore determinant factors.

This is a cross-sectional study using secondary analysis method and the data from 2015 National Study of Health Service Utilization. Study population consists of older people aged ≥60 years. Of these, 8205 were selected as study samples. The data were collected using personal and household questionnaires collecting information on subjects’ need for, referral to, utilization from, and satisfaction with outpatient services. Logistic regression analysis was used to identify factors related to the need, referral, benefit, and satisfaction with the received outpatient services.

 Out of 8205 participants, 3172 (39%) reported the need for outpatient services, of which 66% referred for services; of these, 98% (N=2060) benefited outpatient services. Females, older subjects, villagers, unmarried and illiterate subjects were more in need of outpatient services, but their referrals to receive the services were not more than those of other groups. Lack of basic insurance, supplementary insurance, and a personal care had a significant impact on reducing the number of subjects referred to receive outpatient services. Inability to pay treatment costs (30%), self-treatment (28%) and lack of proper insurance coverage (13%) were the most important reasons for not referring to receive outpatient services. The highest satisfaction was related to the behavior of physicians and medical staff and the lowest satisfaction was related to the cost of outpatient services.

 Although the use of outpatient health services should be based on the need for these services, the present study showed that the older people with higher socio-economic status had higher utilization from the services in Iran. Therefore, there is an inequality in access to outpatient services in the elderly. The reasons for not using outpatient services and dissatisfaction with these services should be seriously considered by health policy makers.