Ali Soroush - Cardiovascular Research Center, Imam Ali Hospital, Kermanshah, Iran
Vajihe Ramezani Doroh - Department of Health Services Management, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
Mozhgan Fardid - Shiraz University of Medical Sciences, Shiraz, Iran
Farideh Moradi - ۴Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
Nadya Baharirad - Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
Sajad Vahedi - Bureau for Health and Social Welfare, Deputy for Scientific, Cultural and Social Affairs, Plan and Budget Organization of the Islamic Republic of Iran, Tehran, Iran

Background: Individuals with the same needs are eligible to use required healthcare services, which is rarely taken into account in health systems. The present research evaluated this issue by investigating the determinants of the need for outpatient healthcare services and subsequent utilization in Kermanshah, western Iran. Methods: This was a before-after cross-sectional study which used two utilization surveys before (۲۰۰۶) and after (۲۰۱۵) the Health Transformation Plan (HTP) in Iran. The surveys were performed in a multi-stage sampling manner, and the data were obtained through face-to-face interviews with household members. ۲۶۲۶ (before) and ۲۰۸۹ (after) subjects who were ≤۱۵ years old completed the surveys before and after the HTP, respectively, and were included in the analysis. The logistic regression was used to analyze the determinants of the needs and utilization of outpatient healthcare services. Results: The need for outpatient healthcare services increased from ۱۹.۷۳% before the HTP to ۲۷.۰۹% after it. The utilization of such services in this period also increased from ۴۴.۷۸% to ۵۷.۹۵%. The logistic regression analysis showed that most factors caused an inverse relationship between the studied outcomes before and after HTP, except for supplementary insurance, which increased both the need for outpatient services and subsequent use. Conclusion: Despite the increased utilization of outpatient services, it seems that some groups still have insufficient access to required healthcare services. Future healthcare reform in Iran must provide enough healthcare services to vulnerable groups.

Healthcare Disparities, Healthcare Services, Needs Assessment, Healthcare Reform