عوامل مرتبط با تصميم گيري خانوارهاي ساكن استان هاي محروم و نسبتا محروم براي ورود به بازار خدمات سلامت

Factors Affecting Decision Making of Households Living in the Deprived Provinces to Enter Health Market

بهبودبخشيدن به وضع تندرستي و تدارك ديدن خدمات بهداشتي و درماني يكي از جنبه هاي اساسي توسعه اجتماعي-اقتصادي را تشكيل مي دهد، زيرا تندرستي كامل و سلامتي يك جنبه اساسي كيفيت زندگي است. ازاين رو هدف اين مطالعه بررسي عوامل موثر بر تصميم گيري خانوارهاي ايراني ساكن در استان هاي محروم و نسبتا محروم براي ورود به بازار خدمات سلامت است. روش در اين مطالعه براي شناسايي عوامل موثر بر تصميم گيري خانوارها از مدل هاي انتخاب نمونه و روش برآورد دومرحله اي هكمن استفاده شده است. قابل ذكر است كه با توجه به مشكل انتخاب نمونه استفاده از مدل هاي انتخاب نمونه براي به دست آوردن برآوردهاي قابل اعتماد، ضروري است. در تدوين مطالعه حاضر از اطلاعات بودجه خانوار مركز آمار ايران بهره گيري شده است و داده هاي مربوط به 6940 خانوار ساكن در استان هاي محروم و 15324 خانوار ساكن در استان هاي نسبتا محروم كشور مورداستفاده قرارگرفته اند. يافته ها جنسيت، بهره مندي از خدمات بيمه هاي درماني، هزينه هاي دخاني، وضعيت تاهل سرپرست، تحصيلات، تعداد كودكان، جوانان و سالمندان، شهرنشيني و سطح توسعه يافتگي استان محل سكونت ازجمله مهم ترين عوامل موثر بر تصميم گيري خانوارهاي ساكن در استان هاي محروم و نسبتا محروم كشور براي ورود به بازار خدمات سلامت هستند. بحث به منظور استفاده مكفي خانوارهاي مناطق محروم كشور از شرايط بهداشتي و درماني، بايد كالاها و خدمات بهداشتي و درماني بيش تري در اين مناطق علي الخصوص نواحي روستايي عرضه شود، در مقاطع تحصيلي گوناگون فرهنگ سازي بهداشتي و درماني موردتوجه قرار بگيرد و برنامه هاي بيمه اي بر پوشش همگاني افراد جامعه متمركز شوند.

Providing the necessary ground for economic growth and development is one of the main goals of policymakers, experts and managers of all governments, especially in developing countries, such as Iran. In this regard, firstly, factors necessary for economic growth and development should be identified and then conditions should be prepared for acceleration of growth and development by promoting and improving situation of these factors. In economic growth literature, physical capital, human capital, and technology have been introduced as the main factors of growth. Although better life or welfare can be understood in different ways, it is necessary to pay attention to people’s health and livelihoods so as to let them take advantage of economic development and motivation to move forward with development (Langlois and et al., 2012). For example, when the workforce plays a role in the production process with all power that expected continue to live after retirement for significant years, and will have the opportunity and health to take advantage of this hard work (Maclean et al., 2015). Improving health and providing health services is an essential aspect of socio-economic development, since health and well-being are can be referred to as a basic aspect of life quality. Therefore, the purpose of this study was to investigate factors affecting decision making of Iranian households living in the deprived provinces to enter the health market. Method In this study, sample selection models and Hackman’s two-step estimation method were used to identify the factors influencing household decision making. It is worth noting that given the difficulty in choosing a sample, it is necessary to use sample selection models to obtain reliable estimates. In this study, household budget information from the Statistical Center of Iran, and data on 6940 households living in deprived provinces and 15324 households living in relatively deprived provinces were used.In this study, STATA software, version 11 was used to examine the factors affecting decision making of Iranian households living in the deprived provinces to enter healthcare market. The reason for choosing the software was its proper features and popularity. In the present study the following hypotheses was examined:- Economic factors (income and insurance) affect decision making of Iranian households living in the deprived provinces to enter healthcare market. Findings The present study classified a quantitative research according to problem nature and its data. Although some descriptive statistics are used in this study, the main method of analysis was parametric type of inferential statistics, and studying the effects of factors impacting on decision making of Iranian households living in the deprived provinces to enter healthcare market using regression. Considering the sample composition in terms of households entering health market, sampling models can be suitable for estimating health care costs of households living in deprived provinces. In other words, the high percentage of households who has not entered the healthcare market led to a non-random sample. Discussion The results show that gender, health insurance services, smoking costs, number of children, the youth and elderly, urbanization, and the level of province development are the most important factors impacting on decision making of households living in deprived and relatively deprived provinces to enter the health market (the coefficients are significant at all three levels of 1%, 5% and 10%). Also, the head of household marital status (that is significant at levels of 5% and 10%) and education (that is significant at levels of 10%) are other factors that can affect decision making of households living in deprived and relatively deprived provinces.As explained, in the Hackman’s two-step method, the selection equation estimated using Probit method, so the coefficients of this equation differ with marginal effects; thus they have not numerical interpretation capability. Accordingly, the analysis related to this equation is limited to expressing how communication (direct or reverse) between explanatory variables and probability of households enter the health market.In order to ensure that households living in the deprived provinces have appropriate health and treatment conditions, more health care products and services in these areas should be provided, especially in rural areas; at various educational levels, health promotion should be considered as culture and; and insurance plans should be focused on covering all members of the community.