Academic journal article Iranian Journal of Public Health

Use of Health Care Services and Associated Factors among Women

Academic journal article Iranian Journal of Public Health

Use of Health Care Services and Associated Factors among Women

Article excerpt


As stated in literatures, one of the most important determinants of health status is health service use (1). So that access to health care might reduce ine-qualities in mortality and self-assessed health (2). Several studies have reported that health service use is a complex type of behavior resulting from a set of determinants including socio-demographic (3) and health characteristics (4), health service organization (5), and the epidemiological profile (6), which can lead to a greater or lower use of services. Accordingly, the proportion of health service use is different around the world, 76.0% in Brazil (7), 78.5% in Thailand (8), and 69.5% in Iran (9). Numerous studies on health service use performed in Iran (9-11) have provided important information about variables associated with the health service utilization in the general population. Different social and individual factors in a study on households living in Markazi Province, indicat-ing that the subjects with female sex, higher household wealth index, fewer years of education, higher income level, as well as those who were insured tend to use the outpatient health services more than other subjects (10). Another study, to examine current patterns of health care-seeking behavior among residents in Tehran, showed that increasing social awareness, continuous education, improving health insurance system and universal coverage may help both the health system to be performed appropriately and utilization of health care services (11).

There was a health service transition in Iran after the Islamic revolution. For example, Imdad (Re-lief) Committee Health Insurance was established in 1979 to provide the basic level of insurance coverage for poor citizens (12). The Medical Ser-vices Insurance Organization was created based on the Public Health Insurance Law in 1994 to cover a wide range of uninsured Iranian popula-tion (13). In addition, an increased government interest in the privatization of health care services has also shown in recent years (14).

Some epidemiological data such as knowing how often the individuals use health care services as well as the factors associated with these episodes are essential within the health net for planning future programs in the sector and for the estab-lishment of public policies. Therefore, the aim of the present study was to investigate the determi-nants of healthcare utilization in women popula-tion in a western district of Iran.

Materials & Methods

This cross-sectional study was conducted in 2012 in the catchment area of five health centers in dif-ferent districts of Sanandaj City, western Iran.

For this survey, five health centers were randomly selected using random numbers table. Based on census method, all women who came to the health centers during the period of data collection (Forty days) and consented to participate in the study were enrolled. Totally, 1200 women were interviewed during the study. Of these, 87.5% agreed to participate. For a detailed description of the study including baseline characteristics of par-ticipants see earlier report (15). After explaining the purpose of the study for each participant, the recruitment procedure started with both written and verbal informed consents.

Our data were collected from an anonymous self-administered questionnaire by a single interviewer that was adequately trained. The questionnaire covers a wide range of demographic characteris-tics including age, education level, place of resi-dence, marital and pregnancy status, household wealth, occupation and duration time of employ-ment, rating of quality of health services, and use of health services. The main outcome variable was use of health services as measured by a question: "Have you used any health services during the past 12 months?" Responses to this question in-cluded "Yes' and "No'. The types of health services that were assessed included hospital and medical office visits (private or insured). …

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