Patient Migration for Hospital Utilization: Case of Iran

Abstract

Introduction: Adequate information about patient using health care facilities is a critical element in planning activities and allocation resources in health sector. In Iran, with performing family physician plan and attempt to reform referral system, the study of mobility of patients between regions (patient migration) has more importance. The aims of the study are: 1) to describe patients’ migration across cities of Iranian Kerman province; 2) to analyze the role of possible determinants affecting the mobility flows. Methodology: using hospital inpatient records of all public hospitals around Kerman province during 2011, we run logit models that compare patients who were admitted in hospital and received health services in cities where they lived and patients received them out of their local hospitals. We studied 21 patient groups according to ICD10 chapters (Appendix 1) to compute the effect of geographic distance, kind of insurance, number of physiccians involved, hospital bed and patient demographic factors. Results: About 40 percent of hospital admissions in Kerman are emigrant patients that quality or quantity of local provided services didn’t satisfy. Constant negative coefficients of geographic distance, hospitals physician and bed and positive coefficients for insurance in all groups do not show any difference in patient migration, between groups. Discussion: According to results of this research, existence of local services, distance, kind of illness and other factors are not more important than patients’ feeling about services in their migration. Paying no attention to this reality in planning health system reforms, especially referral systems, leads to important problems for health system in equity, patient satisfaction and finance aspects.