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Abstract Background The COVID-19 pandemic has impacted global healthcare utilization patterns. This study aimed to examine the impact of COVID-19 pandemic on utilization rate of healthcare services in Iran. Method In this quasi-experimental study, data on the utilization rates of laboratory services, sonography exams, CT scans, MRIs, and EKGs was collected from the Social Security Organization (SSO)’s insurance information system. This data, covering 47 months prior to the pandemic and 25 months during it, was analyzed to assess the pandemic’s impact on healthcare utilization among insured individuals in Iran. The data was categorized into direct, indirect, and total sectors, and an Interrupted Time Series Analysis (ITSA) model was employed for data analysis, examining both total and sector-specific utilization rates. Findings : The study for single group indicated that in the total sector, Utilization rate per 1000 insured significantly decreased by 25.25 for laboratory services, decreased by 3.99 for sonography, decreased by 1.08 for MRIs and decreased by 1.01 for EKGs, but increased by 2.28 for CT scans in the first pandemic month. Over following months, monthly utilization trends per 1000 insured increased significantly- laboratory services + 1.08, sonography + 0.11, CT scans + 0.12, MRIs + 0.06, and EKGs + 0.05. Pre-pandemic, monthly utilization per 1000 insured was 62.68 labs, 14.47 sonography, 0.72 CT scans, 2.06 MRIs, with all significantly higher in the indirect over direct sector except EKGs which were 2.08 higher in the direct sector. In the first pandemic month, there were significant between-sector differences per 1000 of -4.4 for sonography, + 1.89 CT scans, -1.01 MRIs and + 1.29 EKGs. Conclusion The COVID-19 pandemic led to a significant decline in healthcare service utilization, particularly in total and direct sectors, while CT scans remained unaffected. To address these challenges and meet patient needs, Iran’s health system should adopt alternative delivery methods like telemedicine.

Objectives: The aim of this study was to estimate drug prescription indicators in outpatient services provided at Iran Social Security Organization (SSO) healthcare facilities. Methods: Data on all prescribed drugs for outpatient visits from 2017 to 2018 were extracted from the SSO database. The data were categorized into 4 main subgroups: patient characteristics, provider characteristics, service characteristics, and type of healthcare facility. Logistic regression models were used to detect risk factors for inappropriate drug prescriptions. SPSS and IBM Modeler software were utilized for data analysis. Results: In 2017, approximately 150 981 752 drug items were issued to outpatients referred to SSO healthcare facilities in Iran. The average number of drug items per outpatient prescription was estimated at 3.33. The proportion of prescriptions that included an injection was 17.5%, and the rate of prescriptions that included an antibiotic was 37.5%. Factors such as patient sex and age, provider specialty, type of facility, and time of outpatient visit were associated with the risk of inappropriate prescriptions. Conclusions: In this study, all drug prescription criteria exceeded the recommended limits set by the World Health Organization. To improve the current prescription patterns throughout the country, it would be beneficial to provide providers with monthly and annual reports and to consider implementing some prescription policies for physicians.

Background: Considering the increasing growth in health care costs along with the resources finitude; therefore, improving the efficiency and efficient use of resources is considered as one of the main priorities of the health system. The aim of this study was to determine the efficiency of direct medical services affiliated with Iranian Social Security Organization using Stochastic Frontier Analysis (SFA) Method in 2008-2015. Materials & Methods: In this descriptive- analytical study, performance of 30 units of direct medical services affiliated with Iranian Social Security Organization was analyzed using Stochastic Frontier Analysis (SFA) Method. The number of active beds, physicians, nurses and staff were used as inputs and combined variables obtained from factor analysis were selected as output. Frontier version 4.1 was used to determine the efficiency and Stata version 14 was used to study the effective factors on efficiency. Results: The average technical efficiency of studied units was 0.816. Based on the value of index of likelihood ratio test ( LR = 100.45 ), Cobb-Douglas production function was selected as the best model. Conclusion: Based on the findings of this study, adjusting surplus manpower, congenital planning for increasing efficiency and resource management should be the priority of the managers so that they can increase the level of efficiency of studied units and reduce the costs to the least possible.

Background: In the absence of medical facilities in Social Security Organization (SSO) hospitals in provinces, the patients will be dispatched to Tehran. This will dissatisfaction and intellectual and emotional tensions and imposes a lot of costs upon SSO for dispatching the patients . The objective of this study is to compare franchise elimination of medical services in hospitals in contract with social security organization in Provinces with costs of patients dispatching to Tehran .Materials and Methods: The study was done as retrospective and analytical research. The neurosurgical patients dispatched to Tehran were selected for the study (using the census method). The data were collected in information forms. Research finding were analyzed by SPSS software.Results: Among studied provinces, Khuzestan province ,with 233 cases, had the highest frequency of patients dispatched and Zanjan and Golestan provinces with 2 cases had the lowest frequency. There was a significant difference between average of dispatching costs paid by SSO and the average franchise paid by patients (p

Background: Payment method is one of the most important control knobs in the health system. All organizations that mobilize funds for health sector must be decided: who should be paid? Why this money should be paid to them? And how much should be paid? So the main purpose of this study is to identify different methods of paying to the doctors in referral system of selected countries, and ultimately providing some suggestions for Iranian social security organizations- direct medical service provision.Materials & Methods: This was a comparative study designed in 2008. First we studied theoretical issues and analyzed them within the framework of the current situation. Then we conducted a comparative study to find some solutions for it. Then we validated selected suggestions using by Delphi technique.Results: Most selected countries use a combination of methods to pay to the physicians. Usually for employed physicians in insurance organizations, salary makes a large part of doctor`s income. In countries where GPs play the role of gatekeeper, the per capita payment method has a special room. In American Health Maintenance Organizations (HMOs), based on employment or contractual relationship, they pay physicians by one of three methods: "Per Capita", "Salary Monthly" or "Prepayment". In addition to Salaries (if any employment relationship), specialists usually receive some fees for their Services widely.Conclusion: Bonus payment in exchange for quality indicators is considered as a recently developed payment method for both GPs and specialists, but due to wide infrastructures, it needs accurate designing and plenty of arrangements.