Healthcare-seeking behavior and out-of-pocket payments in Erbil, Kurdistan Region of Iraq

• Published in: Journal of health, population and nutrition population and nutrition, 2024-08, Vol.43 (1), p.127-11
• Main Authors: Shabila, Nazar P, Mahmood, Kochr A, M-Amin, Karwan M, Mahmood, Kazhan I, Saleh, Abubakir M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Communicable diseases; Communicable Diseases - economics; Communicable Diseases - epidemiology; Communicable Diseases - therapy; Cross-Sectional Studies; Expenditure; Female; Health; Health care reform; Health Expenditures - statistics & numerical data; Health Services Accessibility - economics; Health Services Accessibility - statistics & numerical data; Hospitals; Humans; Iraq; Male; Medical care, Cost of; Middle Aged; Noncommunicable Diseases - economics; Noncommunicable Diseases - therapy; Patient Acceptance of Health Care - statistics & numerical data; Preference; Private sector; Public sector; Surveys; Surveys and Questionnaires; Young Adult
• ISSN: 1606-0997; 2072-1315; 2072-1315
• DOI: 10.1186/s41043-024-00616-1

Understanding healthcare-seeking behavior and examining health expenditures can help determine possible barriers to accessing healthcare and direct more effective and inclusive healthcare systems. This study aimed to evaluate healthcare-seeking behavior and out-of-pocket healthcare expenditure in a sample of the population in Erbil, Iraq. We conducted this cross-sectional study in Erbil, Kurdistan Region of Iraq, from October to December 2023. A convenience sample of 414 adults completed a self-administered online survey. The following data were collected: recent illness, sociodemographic characteristics, type of healthcare received, and cost of healthcare. The most common health conditions reported were communicable diseases (16.3%), musculoskeletal problems (13.1%), and noncommunicable diseases (12.7%). Approximately 85% of patients with health conditions requiring care sought healthcare; most visited private clinics (46.3%) and private hospitals (18.6%). The median total out-of-pocket healthcare expenditure in US dollars was 117.3 (interquartile range (IQR) = 45.6-410.0). The median total cost was much greater for participants who first visited a private health facility (USD 135.5, IQR = 57.3-405.6) than those who first visited a public facility (USD 76.8, IQR = 16.1-459.7). Participants ≥ 60 years spent significantly more than those