Evidence Based Health Policy, Management & Economics

en Analysis of Compatibility between the Need and Utilization of Health Services in West of Iran: Panel of Two Cross-Sectional Studies Health Economics پژوهشي Original article Background: Individuals with the same needs are eligible to use required healthcare services, which is rarely taken into account in health systems. The present research evaluated this issue by investigating the determinants of the need for outpatient healthcare services and subsequent utilization in Kermanshah, western Iran. Methods: This was a before-after cross-sectional study which used two utilization surveys before (2006) and after (2015) the Health Transformation Plan (HTP) in Iran. The surveys were performed in a multi-stage sampling manner, and the data were obtained through face-to-face interviews with household members. 2626 (before) and 2089 (after) subjects who were ≤15 years old completed the surveys before and after the HTP, respectively, and were included in the analysis. The logistic regression was used to analyze the determinants of the needs and utilization of outpatient healthcare services. Results: The need for outpatient healthcare services increased from 19.73% before the HTP to 27.09% after it. The utilization of such services in this period also increased from 44.78% to 57.95%. The logistic regression analysis showed that most factors caused an inverse relationship between the studied outcomes before and after HTP, except for supplementary insurance, which increased both the need for outpatient services and subsequent use. Conclusion: Despite the increased utilization of outpatient services, it seems that some groups still have insufficient access to required healthcare services. Future healthcare reform in Iran must provide enough healthcare services to vulnerable groups.   Healthcare Disparities, Healthcare Services, Needs Assessment, Healthcare Reform 98 109 http://jebhpme.ssu.ac.ir/browse.php?a_code=A-10-376-1&slc_lang=en&sid=1 Ali Soroush ali.soroush.mhr@gmail.com 0000-0003-4791-4320 No Cardiovascular Research Center, Imam Ali Hospital, Kermanshah, Iran Vajihe Ramezani Doroh vajihe.r@gmail.com 0000-0003-3797-6720 No Department of Health Services Management, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran Mozhgan Fardid mfardid@gmail.com 0000-0002-0501-6218 No Shiraz University of Medical Sciences, Shiraz, Iran Farideh Moradi moradi336@gmail.com 0000-0002-9869-5407 No 4Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran Nadya Baharirad Baharirad777@gmail.com 0000-0002-1019-9928 No Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran Sajad Vahedi vahedi.s3@gmail.com 0000-0002-5698-0699 Yes Bureau for Health and Social Welfare, Deputy for Scientific, Cultural and Social Affairs, Plan and Budget Organization of the Islamic Republic of Iran, Tehran, Iran