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Sagha Abolfazl S F, Emamgholipour S, Yaseri M, Arab M. Comparison of Refugees Inpatient Cos ts Before and After Implementation of Basic Health Insurance in University Hospitals of Tehran Province during 2013 -2017. Iran J Health Insur 2019; 2 (3) :142-150
URL: http://journal.ihio.gov.ir/article-1-104-en.html

Introduction: To achievement Universal Health Coverage, one of the target groups is refugees that have been provided basic health insurance for this population. The purpose of the present study was to compare the inpatient costs, in drugs, surgery, laboratory and other paraclinic, imaging, and resource allocation of inpatient costs and burden of inpatient in the two years before and after basic health insurance.
Methods: This study is a descriptive-analytic and applied type. The research environment was the university hospitals of Tehran province and the statistical population of the refugee hospitalization records during two years before and after the implementation of insurance. Cluster sampling was performed in two stages. At first, 55 hospitals of the province, 15 hospitals and then 1575 samples in each period, were randomly selected. Data were analyzed by SPSS.
Results: By implementation of basic health insurance, the average share of refugees from inpatient costs was 13.50% (P <0.001), the share of supplementary insurance was 0.04% (P <0.001), the share of hospital discounts was 9.99% (P <0.001). Burden of inpatient increased by 52% (P <0.001). The average share of drug and surgery costs decreased by P = 0.002 and P <0.001, respectively, and imaging services increased by P <0.001. Laboratory and other para clinics did not show a significant difference.
Conclusion: Basic health insurance reduced patient share and hospital discounts and increased burden of inpatient. However, given the low population coverage, it seems necessary to reconsider the dimensions of Universal Health Coverage, and especially population coverage.