Aboghasem Pourreza - Department of Health Care Management and Economics, School of Public Health, Tehran University of MedicalSciences, Tehran, Iran
Iraj Harirchi - Department of surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Bazyar - Department of Health Promotion, School of Public Health, Ilam University of Medical Sciences, Ilam, Iran

Background: The Cancer Institute of Iran, located in Tehran (Iran’s capital city),is a national specialized center for cancer. Cancer patients from all over the countryrefer to it. This study compared the out-of-pocket (OOP) expenditures of patientsfrom Tehran and patients from other parts of Iran who were hospitalized in thiscenter.Methods: This cross-sectional study included all patients over 18 years of age withhead and neck or digestive system cancer who were actively undergoing primarytreatment in the Cancer Institute of Iran located in Tehran (the capital city). Datawas collected through a structured interview with the patients themselves and/ortheir companions and then analyzed using SPSS16 software.Results: Direct medical costs of patients from Tehran were much higher than thoseof patients from other provinces. In contrast, the average direct non-medical costsincluding transportation, accommodation, food, etc. of patients from otherprovinces were significantly higher than those of patients from Tehran, and 53% ofpatients borrowed money for their treatments.Conclusion: It seems necessary to develop new supportive policies to alleviatefinancial costs for cancer patients and help them manage their cancers effectively.Patients from the provinces faced additional costs for travel, food, andaccommodations which complicated their access to special services. Establishingand improving specialized cancer centers in other cities can reduce the burden ofout-of-pocket expenditures for patients from remote areas.

Out-of-Pocket Expenditures, Direct Medical Costs, Cancer Patients