نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری اقتصاد سلامت، مرکز تحقیقات علوم مدیریت و اقتصاد سلامت، دانشگاه علوم پزشکی ایران، تهران، ایران

2 مرکز تحقیقات علوم مدیریت و اقتصاد سلامت، دانشگاه علوم پزشکی ایران، تهران، ایران

3 استادیار، گروه اقتصاد سلامت، دانشکده مدیریت و اطلاع رسانی پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران

4 استادیار سیاستگذاری سلامت، مرکز تحقیقات ارتقاء سلامت، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران

چکیده

مقدمه: جمعیت سالمند سهم قابل ملاحظه­ای از تقاضا برای خدمات بهداشتی درمانی را تشکیل می­دهند و در نتیجه هزینه خدمات ارائه شده به این قشر از منظر اقتصاد سلامت حائز اهمیت می باشد. لذا این مطالعه با هدف برآورد هزینه‌های مستقیم و غیرمستقیم سالمندان مراجعه کننده به مراکز آموزشی درمانی منتخب دانشگاه علوم پزشکی ایران انجام شد.مواد و روش: این مطالعه مقطعی در بین 400 سالمند مراجعه کننده به مراکز آموزشی درمانی فیروزگر و رسول اکرم (ص) تهران در سال 1394 انجام گرفت. هزینه‌های مستقیم درمانی و غیر درمانی و هزینه‌های غیر مستقیم با استفاده از فرم گردآوری اطلاعات هزینه‌ای جمع آوری شدند. سپس داده های جمع ­آوری شده، توسط نرم افزار SPSS.16 مورد تجزیه و تحلیل قرار گرفتند.یافته­ ها: در این مطالعه میانگین کل هزینه‌های سالمندان برای یک دوره یک ماهه 3801081 ریال برآورد گردید. هزینه‌های مستقیم درمانی با میانگین 2992276 ریال بیشترین سهم و هزینه‌های غیر مستقیم با میانگین 217088 ریال کمترین سهم را از کل هزینه‌های سالمندان تحت بررسی داشتند.بحث و نتیجه­ گیری: اگرچه هزینه‌های مستقیم درمانی بیشترین بار مالی را بر بیماران سالمند دارد، اما هزینه‌های مستقیم غیردرمانی و هزینه‌های غیرمستقیم نیز بیش از 20 درصد هزینه‌های سالمندان را تشکیل داده ­اند، لذا در برنامه ­ریزی و سیاست‌گذاری برای نظام سلامت باید تمام اجزای هزینه ­ای مدنظر قرار گیرد.

کلیدواژه‌ها

عنوان مقاله [English]

An Estimation of Direct and Indirect Costs for Elderly Patients in Tehran, 2015

نویسندگان [English]

  • Javad Javan-Noughabi 1
  • Aziz Rezapour 2 3
  • Fatemeh Setoodezadeh 4
  • Amir Ali Moradpour 1

1 PhD Student in Health Economics, Health Management and Economics Research Center, Iran University of medical sciences, Tehran, Iran

2 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran|Assistant Professor, Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

3 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran|Assistant Professor, Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

4 Assistant Professor of Health Policy, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

چکیده [English]

Background: Elderly population constitute a significant share of demand for health services and thus the cost of services provided to this population is important from health economic perspective. Therefore, this study aimed to estimate the medical and non-medical direct and indirect costs among elderly population who referred to selected hospitals of Iran University of Medical Sciences.
Method: This cross-sectional study was conducted on 400 elderly patients admitted to Firouzgar and Rasoul Akram hospitals in 2015. Medical and non-medical direct and indirect costs were collected using a checklist and the data were analyzed with an SPSS statistical software.
Results: In this study, the mean cost of elderly patients was 3,801,081 Rials for one month. Direct medical costs had the highest share and the indirect costs had the lowest share of the total cost for elderly patients (2,992,276 and 217,088 Rials, respectively).
Discussion and Conclusions: Although direct medical costs had the highest financial burden on older patients, the non-medical direct and indirect costs also constituted more than 20% of the total cost for elderly patients. Therefore, all components of costs should be considered in the planning and policy-making in the health system.

کلیدواژه‌ها [English]

  • Direct cost
  • Indirect cost
  • Elderly
  • Iran
  1. Canbaz S, SÜNTER AT, Dabak S, PEKŞEN Y. The prevalence of chronic diseases and quality of life in elderly people in Samsun. Turkish Journal of Medical Sciences. 2003; 33(5):335-40.
  2. Organization WH. Definition of an older or elderly person: proposed working definition of an older person in Africa for the MDS Project. URL: http://www who int/healthinfo/survey/ageingdefnolder/en/index html [accessed 2012-11-03][WebCite Cache]. 2013.
  3. Nations U. World Population Prospects Cd-rom 2008 Revision: United Nations Publications; 2009.
  4. Lunenfeld B. The ageing male: demographics and challenges. World journal of urology. 2002; 20(1):11-6.
  5. McGarry SA, Engemann JJ, Schmader K, Sexton DJ, Kaye KS. Surgical-Site Infection Due to Staphylococcus aureus Among Elderly Patients Mortality, Duration of Hospitalization, and Cost. Infection Control & Hospital Epidemiology. 2004; 25(06):461-7.
  6. Nagamine M, Jiang HJ, Merrill CT. Trends in elderly hospitalizations, 1997–2004. 2006.
  7. Soltani MH, Sahaf R, Mohammadi Shahbolaghi F, Ghaffari S, Khosravi A, Gohari MR. Elderly, duration of hospitalization and Hospital cost in Milad Hospital in Iran. Iranian Journal of Ageing. 2012; 6:58-65. (Persian)
  8. Heider D, Matschinger H, Müller H, Saum K-U, Quinzler R, Haefeli WE, et al. Health care costs in the elderly in Germany: an analysis applying Andersen’s behavioral model of health care utilization. BMC health services research. 2014; 14(1):71.
  9. Spillman BC. Changes in elderly disability rates and the implications for health care utilization and cost. Milbank Quarterly. 2004; 82(1):157-94.
  10. Habibi A, Neekpoor S, Seyedolshohda M, Haghani H. Health promotion behaviours and Quality of life among elderly people: A crosssectional survey 2006. Journal of Ardabil University of Medical Sciences. 2008; 8(1):29-36. (Persian)
  11. Saberian M, Aghajani H, Ghorbani R. Survey of socio economic and health Statues of elderly people urban aria of Semnan University of medical sciences in 2000. Semnan University of medical sciences journal. 2002; 4(3):4. (Persian)
  12. Alizadeh M, Khoshbin S, Khavarpou F. Quality of life, Welfare and Depression of Iranian resident of Sydney of Australia. The Iranian Journal of Aging. 2009; 4(4):56-63. (Persian)
  13. Ziloochi MH, Pourreza A, Akbari F. Evaluating the hospitalization costs for elderly patients in teaching hospitals of Kashan university of medical sciences during 2009-10. Feyz Journals of Kashan University of Medical Sciences. 2012; 16(1):86-94. (Persian)
  14. Zandi S. The Survey of Distribution, Causes and Costs of Hospitalization of Old Patients Supported by Medical Services Insurance Organization in Sanandaj Besat Hospital, [MPH Dissertation]. Tehran Tehran University of Medical Sciences. 2008; (Persian)
  15. Murray ME, Wells TJ, Callen BL. Hospital resource utilization and functional decline of geriatric patients. Nursing Economics. 2003; 21(3):114.
  16. Piroozi B, Moradi G, Esmail Nasab N, Ghasri H, Farshadi S, Farhadifar F. Evaluating the effect of health sector evolution plan on cesarean rate and the average costs paid by mothers: A case study in Kurdistan province between 2013-2015. Journal of hayat. 2016; 22(3):245-54. (Persian)
  17. Delpisheh A, Mansourian M, Rastgarimehr B, Shokohi Ardebili S, Babanejad M, Qorbani M, et al. The evaluation of health and socio-economic status of elderly people in Ilam province in 2011. Iranian Journal of Diabetes and Metabolism. 2014; 13(6):495-504. (Persian)
  18. Totonchi P. Prevalence of chronic disease among elder and some aging characteristics of elder with disability in old people under cover of Commiteh Emdad Imam Khomaini of Tehran city. Payesh Journal. 2004; 3(3):219-25. (Persian)