Calculation of the total cost of patients referring to the university outpatient centers in Qazvin city:2017

Background and aim: The cost of health care, in other words, the medical direct cost, is only a small fraction of the total cost of the illness. Patients, in addition to medical direct costs (health care expenditure), bear non-medical direct costs and indirect costs that are not included in the calculation of health care expenditure or catastrophic health expenditures and are not counted. These costs add to the out of pocket payments of patients. Hence, it is necessary to calculate the total cost of patients for policy and health decisions. Therefore, the aim of this study was to determine the total cost of patients referred to a university outpatient centers in Qazvin city. Material and Methods: In this study, an overview interview was used to collect cost data from outpatients referring to the internal clinic. Demographic and socioeconomic data were also collected. 341 outpatient,s were randomly selected and interviewed. The total cost of outpatient care includes: medical direct costs, non-medical direct costs, and indirect costs for patients, Companion patient, and caregivers. Results: The direct costs of most patients cost and indirect costs that resulted in lost income due to absence from work has been a small part of the cost of patients. The medical direct cost had the largest (61%) share of the total cost. There was a significant relationship between sex with direct and indirect costs and total cost (P-value < 0.05). Increasing age, lower education, and being male was associated with a significant increase in total cost (P-value < 0.05). Conclusion: According to the results of the study, it is recommended that policy-makers and health care decision-makers not only focus on direct medical costs. Because non-medical direct costs add to the amount of payment from the pocket of the patient and relatives. In addition, the disease causes decrease and loss of income for the patient and relatives. Therefore, the two factors that increase pay out of pocket and loss of income will cause the person to face catastrophic expenditures and to fall into the poverty trap. Keywords: Total Cost of Outpatients, Direct Cost, Indirect Cost, Qazvin