Shiraz E-Med J. 2017 August; 18(8):e57570. Published online 2017 July 15. doi: 10.5812/semj.57570. Research Article Factors Affecting the Utilization of Outpatient Health Services and Importance of Health Insurance Farhad Lotfi, 1 Soraya Nouraei Motlagh, 2 Ghadir Mahdavi, 3 Khosro Keshavarz, 1 Mohammad Hadian, 4 and Hassan Abolghasem Gorji 5,* 1 Health Human Resources Research Center, School of Management & Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran 2 Public Health Department, School of Health and Nutrition, Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, IR Iran 3 ECO College of Insurance, Allameh Tabataba’i University, Tehran, IR Iran 4 Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran 5 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, IR Iran * Corresponding author: Hassan Abolghasem Gorji, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, No. 6, Rashid Yasemi st., Vali-e-asr Ave., Tehran, IR Iran. Tel: +98-2188794302, Fax: +98-2188883334. E-mail: gorji.h@iums.ac.ir Received 2016 December 03; Revised 2017 April 09; Accepted 2017 April 29. Abstract Background: Research on the utilization of health services provides an opportunity to identify and determine the quantity and quality of factors, which can facilitate or debilitate access to services. Policymakers believe that factors affecting the use of health services should be quantified in order to allocate further resources to indicators, which can help reduce inequalities. This study aimed to investigate factors affecting the utilization of outpatient services and to determine the effect of health insurance on finan- cial support for individuals. Methods: The present study included all Iranian households, which had been recruited by the Statistical Center of Iran in 2012 - 2013. The data were analyzed in 2 logit models and divided into urban and rural areas. Results: According to the results, basic and full insurance coverage was the main factor, influencing the utilization of outpatient health services. Furthermore, age composition of households affected their utilization of these services. More precisely, households with more members aged < 5 or > 65 years tended to use outpatient services more frequently. In addition, households with female heads and those from higher decile groups were more likely to use outpatient services. On the contrary, educational level and house- hold size had negative effects on demand for outpatient health services. Conclusions: Based on the results, there was a significant association between social and economic status and utilization of out- patient services. For decreasing the observed inequalities, policymakers should pay particular attention to households with low income and members aged < 5 or > 65 years and provide access to health services for these groups (eg, access to family physicians). Keywords: Utilization, Health Insurance, Outpatient Health Services 1. Background One of the objectives in the evaluation of people’s de- mands and utilization of health services is to identify ma- jor factors influencing the use of these services. A better understanding of these factors helps stakeholders and pol- icymakers have a comprehensive image of different vari- ables influencing the utilization of health services; in ad- dition, it can help predict the use of these services in differ- ent populations. Use the limited resources efficiently and spend public funds on the suitable and effective services, as well as. Identification of these factors is a method for accurate estimation of health resources (1, 2) and macroe- conomic policymaking in the health sector (3). In fact, re- search on the utilization of health services helps identify factors, which facilitate or prevent access to these services (4). Based on the findings of previous studies, a number of predisposing factors (eg, gender, place of residence, oc- cupation, and educational level), empowering factors (eg, health insurance and income), and need-related factors have been identified as predictors for utilization of health services (5, 6). In this regard, one of the major factors af- fecting the utilization of health services is socioeconomic status. Recent studies have indicated that utilization of health services is associated with people’s gender, place of res- idence, and socioeconomic status (7). For instance, women’s low social status in some regions might discour- age them against the use of health services. This problem is exacerbated when other household members (especially husbands) are reluctant to accept the costs of health ser- vices and refuse to devote enough time to a long-term treat- ment (8). Previous findings have also demonstrated the positive Copyright © 2017, Shiraz E-Medical Journal. 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