title: Study of Out-of-Pocket Expenditures for Outpatient Imaging Services in Imam-Khomeini Hospital in 2014.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Assistant Professor, Faculty of Health Care Management, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sima
authors.initials: S
authors.lastname: Marzban
authors.affiliation: M.Sc. of Health Care Management, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Alborz University of Medical Sciences, Shahid Sabzeparvar Health Center, Alborz, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Rajaee
authors.affiliation: M.Sc. Student of Health Services Management, Metabolic Diseases Research Center, Qazvin University of Medical Science, Qazvin, Iran.
authors.forename: Soheyla
authors.initials: S
authors.lastname: Gholami
authors.affiliation: Ph.D. of Health in Emergencies and Disasters, School of Health, Safety, and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Meysam Safi
authors.initials: MS
authors.lastname: Keykale
authors.affiliation: M.Sc. of Health Care Management, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Emam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Marziye
authors.initials: M
authors.lastname: Najafi
keywords: imaging services; out-of-pocket payment; outpatient services