Razi Journal of Medical Sciences

Background: Having knowledge about utilization of health care services is necessary for resource allocation and scheduling in health sector. The general consensus is that the inequality in the utilization of health care is unjust and unfair and health care systems should ensure equal access to health care based on need.

Methods: The main objective of this study was to identify factors influencing the utilization of health services, inpatient and outpatient both in the public and private sectors using logit econometric models. Domain of this study is 2011 and all regions of Tehran are considered. Urban HEART questioners’ data was used in this research. Gathered data were analyzed and interpreted in several stages and in the form of several logit models for inpatient services, outpatient services and private and public services.

Results: The research findings showed that in 2011, overall 40.07% of the populations of Tehran have used outpatient health services and 18.69% of inpatient services. The main reasons for not utilization of outpatient services was reported existing of medicine and self-treatment at home and after that were having no money and services expensiveness and resolve the problem. Between reasons for not utilization of inpatient services, having no money and services expensiveness and lack of the expertise required for households were more important than other factors. After estimation of logit models the income, education, employment status, insurance and household size have been diagnosed effective on health services utilization. Existence of patients with chronic disease in households was the most effective factor on health care utilization in both inpatient and outpatient service groups.

Discussion: Policy makers in health sector need to improve financial or economical access to health services, and in this regard, the identification of households in the bottom expenditure deciles, living in deprived regions, households with people over 60 and less than 5 years or patient with chronic disease will be a good help for planning for increase in health services accessibility.