Background: Direct out-of-pocket (OOP) payment is the most inequitable way to pay for healthcare services, and this trend exposes patients and their families to backbreaking financial risks. The aim of this study was to estimate the out-of-pocket expenditures for outpatient imaging services in Imam-Khomeini Hospital in Tehran. 

Methods: This cross-sectional study was conducted in 2014 on 100 users of outpatient imaging services (radiology, ultrasonography, CT-scan, and MRI) in Imam-Khomeini Hospital in Tehran. Structured interviews and the analysis of related documents were used to acquire the pertinent data. The percentage of out-of-pocket expenditures was obtained by dividing the out-of-pocket expenditures by the total expenditures paid to the service provider, i.e., the sum of out-of-pocket expenditures and insurance payments. To analyze the data, we used descriptive-analytic statistics, distribution indices, the t-test, and the Pearson product-moment correlation coefficient. 

Results: Health insurance covered 84% of costs incurred by users of outpatient imaging services. There was no significant relationship between the user’s age and the amount of out-of-pocket expense (p = 0.01). The relationship between the user’s gender and out-of-pocket expense was significant (p = 0.05). The average payment for males was greater than the average payment for females. The highest percentage of the total payment the users incurred was 41% for a CT-scan, and the lowest percentage the users incurred was 30% for radiology services.  

Conclusion: It is suggested that expensive diagnostic tests, such as CT-scans, be prescribed according to the actual needs of patients to make the financial burden of diagnostic services reasonable for all patients.

Keywords: out-of-pocket payment; imaging services; outpatient services
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July-September 2019 (Volume 11, Issue 3)


Previous Issue

In the second issue of the journal Electronic Physician for 2019, we have several papers including four Randomized Controlled Trials, a model development study, a case report, an editorial, a letter to editor (LTE), and several original research including two studies with qualitative approach. Authors of this issue are from nine countries: Iran, The Netherlands, Sweden, Italy, India, Thailand, Saudi Arabia, United Arab Emirates (UAE), and Jordan. Read more...


The 6th World Conference on Research Integrity (WCRI) is to be held on June 2-5, 2019 in Hong Kong.

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Deadline for submission: 7 March 2019, 16:00 (GMT)

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Don't miss this exceptional opportunity to learn how to perform and report a Meta-analysis correctly. Two Meta-analysis workshops are organized in April and May 2019 by Dr. Michael Borenstein in New York, USA (April 08-10, 2019) and London, UK (May 27-29).

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Dr. Michael Borenstein, one of the authors of Introduction to Meta-Analysis, is widely recognized for his ability to make statistical concepts accessible to researchers as well as to statisticians. He has lectured widely on meta-analysis, including at the NIH, CDC, and FDA. Read more: