The Association between Family Socio-Economic Status and Health Care Utilization in Ghaemshahr-Mazandaran, Iran

Abstract

Background and purpose: Equity in access to health care has become a desirable policy objective. Therefore, accessibility to health care should be provided based on health needs rather than sociodemographic variables. This will lead to a better utilization of health care and improvement of equity in health. The aim of this paper is to examine the effects of family socio-economic status as an indication of individual's socio-economic status on the utilization of their health care. Materials and Methods: This was a cross-sectional study conducted in Ghaemshahr County, Iran in early 2013. In this household survey, 807 individuals were randomly approached at their home. A self-designed questionnaire was applied. The parent or every individual above 18 years were asked to fill the questionnaire for themselves and other member of their family. Using SPSS software analyses were performed with employing correlation coefficient, Chi-square and t-test. Results: About 47.9% and 52.1% of respondents were living at urban and rural area respectively. Respondents were from a quite different socio-economic and demographic background. Utilization of health care had only significant association with the location of respondents. Underutilization of health care has proportionately more evident in a rural area compared with the urban area. Conclusion: Accessibility to and utilization of health care was lower in a rural area. There is a concern of inequity in health at rural area and is going to be expanded. Appropriate policy and intervention are required to improve the situation.

The economic standpoint of referral system at using tertiary hospital services in Iran

“…Bypassing referral system from a wide range of population into a specialist teaching hospital happened where nearly all patients have already been covered by a capitation-based FPs. This could be interpreted as deficiencies in the components of referral system in Iran (2), and the deficiencies that have been felt by FPs in previous study in the same province (13)(14)(15)37). Dealing with such fundamental problems requires appropriate and systematic consideration rather than segmental deficient interventions with poor infrastructural requirement (2).…”

“…According to the Aday and Andersen model for access and utilization of care, multiple factors may influence utilization of health services. Such factors may include characteristics of the population at risk and characteristics of the healthcare delivery system (12)(13)(14)(15)(16)). An effective referral system ensures a close relationship between all levels of the health system and helps to ensure people receive the best possible care closest to home.…”

“…In many developing countries, a high proportion of clients seen at the outpatient clinics at secondary facilities could be appropriately looked after at primary healthcare centers at lower overall cost to the client and the health system. The design and functioning of a referral system in any individual country will be influenced by many factors such as capabilities of lower levels, availability of specialized personnel, training capacity, organizational arrangements, cultural issues, political issues, traditions, population size, and density, terrain and distances between urban centers, pattern and burden of disease, and demand for and ability to pay for referral care as either health systems determinants or general determinants (13)(14)(15)(16)(17). The aim of this research was then to investigate socio-economic and health seeking behavior of caretakers at using hospital services in Iran.…”