Healthcare services utilization in Iran: a systematic review and meta-analysis

Abstract

Purpose It can be said that the most important function of the health system is to provide health-care services. This directly affects society’s health and justice. To the best of the authors’ knowledge, this study is the first study that has meta-analyzed the percentage of health services utilization among Iranians to answer this question “How much is the percentage of health-care services utilization in Iran?” Design/methodology/approach This study is a systematic review and meta-analysis conducted in 2020. The literature review was done by searching the databases of Google Scholar, Scopus, PubMed, Web of Science, Science Direct, SID, Magiran and Irandoc from January 2010 to August 2020. Pooled utilization percentage (UP) was estimated by STATA 15 through random-effects meta-analysis with 95% confidence interval. The I2 statistic was used to investigate the possibility of heterogeneity of articles (I2 ≥ 50% indicate heterogeneity). A forest plot was applied to report the results. A funnel plot exploited due to publication bias assessment. Findings Approximately 22% of the reviewed articles have been done at the national level of Iran. Most studies have examined the utilization of outpatient and inpatient services. Based on the random effects method, the pooled value of UP was obtained at 47.82%, (95% CI: 39.33–56.31). Also, the pooled percentage of utilization was statistically significant (Test of UP = 0, Z = 456.44, p = 0.000). Practical implications Policymakers can improve the level of utilization from health services by expanding universal coverage, expanding insurance coverage and removing direct and indirect barriers. Originality/value To the best of the authors’ knowledge, this is the first systematic review and meta-analysis on health services utilization in Iran that completely considers the utilization rate in all health services and states the practical solutions to cope with utilization deficiencies and barriers.