Out of Pocket Payment for Obstetrical Complications: A Cost Analysis Study in Iran

BACKGROUND: This study was conducted to determine the total expenditure and out of pocket payment on pregnancy complications in Tehran, the capital of Iran. METHODS: A cross-sectional study conducted on 1172 patients who admitted in two general teaching referral Hospitals in Tehran. In this study, we calculated total and out of pocket inpatient costs for seven pregnancy complications including preeclampsia, intrauterine growth restriction (IUGR), abortion, ante-partum hemorrhage, preterm delivery, premature rupture of membranes and post-dated pregnancy. We used descriptive analysis and analysis of variance test to compare these pregnancy complications. RESULTS: The average duration of hospitalization was 3.28 days and the number of visits by physicians for a patient was 9.79 on average. The average total cost for these pregnancy complications was 735.22 Unites States Dollars (USD) (standard deviation [SD] = 650.53). The average out of packet share was 277.08 USD (SD = 350.74), which was 37.69% of total expenditure. IUGR with payment of 398.76 USD (SD = 418.54) (52.06% of total expenditure) had the greatest amount of out of pocket expenditure in all complications. While, abortion had the minimum out of pocket amount that was 148.77 USD (SD = 244.05). CONCLUSIONS: Obstetrics complications had no catastrophic effect on families, but IUGR cost was about 30% of monthly household non-food costs in Tehran so more financial protection plans and insurances are recommended for these patients.