Medical service load and accessibility: Modeling and comparison in Tehran districts

Measuring the demand for medical services is necessary not only for organizing tertiary preventive care but also in planning first- and second-level intervention programs. This study aimed to determine:- The medical demand - The load of medical service utilization - The medical demand and medical service utilization in different districts of Tehran and in people with different characteristics. This was a cross-sectional study carried out in Tehran. We used random, multi-stage sampling and a total of 5973 subjects were selected for the study. Data were collected by means of a questionnaire.The data included demographic information, medical complaints and utilization of medical services. We studied a total of 5973 individuals, who came from 1416 different families.The result showed that for every 100 people in Tehran, there were 122 demands for medical service and 102 cases of service utilization in one year. The remaining 20 demands did not lead to service utilization. We also detected statistically significant differences in demand between different age groups and between men and women. Other notable findings included:- Significant differences in demand, utilization and accessibility among different districts in Tehran.- After influenza and common cold, the following groups of illnesses most frequently led to demands for medical services: musculoskeletal, cardiovascular, and neuropsychological diseases. In this study, every 100 people had 122 demands for medical services per year, 102 of which had received related services. After common cold and influenza, cardiovascular, musculoskeletal and neuro-psychological diseases were the most important diseases groups in terms of services demands. In light of the relationship between demands and factors such as age, sex and place of residence in Tehran there is a need for effective planning of preventive, treatment and rehabilitation services (3 levels of prevention). This is especially true for the more common diseases and in groups considered to be at high risk. This could contribute significantly towards achieving greater health equity. Moreover, using demand rates, the health sector can calculate workload and estimate the number of health providers required for the people of Tehran.