Analysis of Compatibility between the Need and Utilization of Health Services in West of Iran: Panel of Two Cross-Sectional Studies

Background: Individuals with the same needs are eligible to use required healthcare services, which is rarely taken into account in health systems. The present research evaluated this issue by investigating the determinants of the need for outpatient healthcare services and subsequent utilization in Kermanshah, western Iran. Methods: This was a before-after cross-sectional study which used two utilization surveys before (2006) and after (2015) the Health Transformation Plan (HTP) in Iran. The surveys were performed in a multi-stage sampling manner, and the data were obtained through face-to-face interviews with household members. 2626 (before) and 2089 (after) subjects who were ≤15 years old completed the surveys before and after the HTP, respectively, and were included in the analysis. The logistic regression was used to analyze the determinants of the needs and utilization of outpatient healthcare services. Results: The need for outpatient healthcare services increased from 19.73% before the HTP to 27.09% after it. The utilization of such services in this period also increased from 44.78% to 57.95%. The logistic regression analysis showed that most factors caused an inverse relationship between the studied outcomes before and after HTP, except for supplementary insurance, which increased both the need for outpatient services and subsequent use. Conclusion: Despite the increased utilization of outpatient services, it seems that some groups still have insufficient access to required healthcare services. Future healthcare reform in Iran must provide enough healthcare services to vulnerable groups.