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Healthcare Utilization and Expenditures Among Iranian Chemical Warfare Survivors Exposed to Sulfur Mustard Publisher Pubmed



Mehdizadeh P1, 2 ; Ghanei M3 ; Pourreza A1 ; Akbarisari A1 ; Mousavi B4 ; Darroudi R1
Authors
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Authors Affiliations
  1. 1. Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
  3. 3. Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
  4. 4. Prevention Department, Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran

Source: Archives of Iranian Medicine Published:2022


Abstract

Background: This study aims to explore the healthcare utilization (HCU) and expenditures from complementary health insurance among Iranian people who survived sulfur mustard (SM) exposure during the Iran-Iraq war. Methods: This study was conducted between March 21, 2018 and March 21, 2019 using secondary data. Data on the HCU and expenditure of war survivors after their exposure to SM were obtained from the Iran Veterans and Martyr Affair Foundation (VMAF) database and the national complementary insurance organization that covers their medical expenses. Multiple linear and zero-inflated poison regression (ZIP) models were used to estimate the costs and HCU. Analyses were performed in R software version 3.6.3. Results: Among 58 880 survivors who were included in study, 36 383 (61.7%) used at least one service during a year. The total frequency of HCU was 15.6 services per person per year. The annual mean medical cost of each survivor was US$807.6 (± 2901.2). The highest number of utilizations was related to medicine and physician visits. The highest median cost was related to rehabilitation (US$151.7), medical equipment (US$84.5), medicine (US$83.3) and inpatient services (US$ 48.8). With increasing age, disability, weight, severity of injury in lung or eye injuries, the rate of health service utilization rose significantly. Conclusion: Over 30 years after the Iran-Iraq war, Iranian people who were exposed to SM and survived still suffer from injuries and pose a significant drain on healthcare resources. © 2022 The Author(s).