# Financial challenges in Iran’s healthcare system arising from migrant populations: evidence from two hospitals in Yazd Province

## TL;DR

This study examines how migrant populations, particularly Afghans, contribute to financial burdens and access issues in Iran's healthcare system.

## Contribution

The study provides new empirical evidence on uncompensated healthcare costs and bed occupancy rates caused by migrants in two hospitals in Iran.

## Key findings

- 10% of inpatients in the studied hospitals were Afghan, with 18.5% of their healthcare costs remaining uncompensated.
- 77% of Afghan patients lacked health insurance coverage, contributing to financial strain on the healthcare system.
- Emergency services were the most frequently used by Afghan patients, highlighting access patterns and system pressures.

## Abstract

A review of the literature on the issues faced by foreign nationals in the area of health economics shows that researchers have mainly focused on the problems of immigrants and refugees in accessing health care services but the problems of the health system, particularly hospitals has been overlooked in this regard. The aim of this study is to investigate the uncompensated healthcare costs and the bed occupancy rates of the two main hospitals in Yazd province, due to immigrants.

This descriptive and applied study was conducted in 2023 and 2024 in Yazd province, Iran. The study population included all documented inpatients of two hospitals affiliated to Shahid Sadoughi University of Medical Sciences, Shahid Rahnemoon and shahid Sadoughi. The sample size of the study was 338,886 hospitalized patient records. The data was extracted from the HIS system, and then categorized and analyzed using Excel 2019.

From 304,202 inpatients in two hospitals 34,425 (10%) were Afghani. Each patient had about 5926 dollars cost for health care system and 18.5% of costs were remain uncompensated. 77percents of patients were not under any health insurance coverage. The most used service was emergency services.

Despite the existence of simple laws for Afghan insurance in Iran, they have little interest in getting insured, which has turned into a financial burden for the healthcare system in the country. Additionally, the large number of Afghan patients in public healthcare units has become a barrier to access affordable medical services for Iranian patients.