The Healthcare Costs in the Aging Based on Data from the Urban Health Equity Assessment and Response Tool Project in Tehran, Iran (UHEART-2)


1 Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

2 Physiology Group, Department of Medicine, Shahed University, Tehran, Iran

3 Management Group, Iran University of Medical Sciences, Tehran, Iran

4 Social Medicine Group, Department of Medicine, Iran University of Medical Sciences, Tehran, Iran

5 Tehran Municipality Healthcare Administration, Tehran, Iran

6 Health Services Management, Health Services Management Department, Health School, Baqiyatallah University of Medical Science, Tehran, Iran

7 Department of Healthcare Services Management, Health School, Baqiyatallah University of Medical Sciences, Tehran, Iran


Introduction: The urban life and the problems of megalopolises have caused families to fail paying attention to the aging. According to the viewpoint from the experts in healthcare fields; the rising population of the aging in the country will expose the related social organizations and institutions with complex difficulties in an imminent outlook. The present study has dealt with this topic by means of the data derived from the project “Urban Health Equity Assessment and Response Tool (Urban HEART-2)” which has been implemented in the Municipality of Tehran in 2011.
Methods: This study is an applied type and its data has been gathered by a cross-sectional technique. In order to collect information in 22 districts and 368 neighborhoods in Tehran, data were collected by using a multi-stage sampling technique. The total sample size included 1’117’845 people and statistical analyses were done on 15’030 old participants. Similarly, the needed data in this study in non- old group were examined in 102’355 people. Likewise, the related data to healthcare costs and the needed data for the calculation of catastrophic costs were extracted from both of old and non- old groups (<60 years). In this study, the mean healthcare costs of diseases was explored in both groups of the aging and the ones under the age of 60. The catastrophic healthcare costs were calculated for the two studied groups by means of the method confirmed by the World Health Organization (WHO).
Results: The findings from this research show that the old age rate in Tehran is higher in compared to this rate throughout the country. In a statistical survey conducted on healthcare cost index, a significant difference with a confidence interval (99%) was observed in two age groups under 60 years of age (non- old people) and over 60 years of age (aging). A review on hospitalization costs, diagnostic services cost, medical examination and transportation costs for medical services in both groups of the aging and those under the age of 60 indicated that a significant difference was seen at a confidence level of 99% while 12.9% of the families with old members might incur catastrophic healthcare costs. At the same time by exploring in catastrophic healthcare costs in both groups of the aging and those under the age of 60 a significant statistical difference was seen among both studied groups.
Conclusion: The Iranian healthcare system is exposed to challenge the high- rising of such costs like other medical systems. The results of this study indicates that the healthcare costs and catastrophic healthcare expenses are at high level in the families with old members in Tehran. The rising catastrophic costs in the aging may be due to many reasons such as high percentages of personal payment and inadequate coverage by insurance. It seems that the supporting policies and the exemptions from the payment of healthcare costs should be employed to reduce the percentage of exposing the families to catastrophic healthcare costs for the aging as a specific population group.