Study of the ex-post moral hazard of laboratory services in Iran

The basic health insurances cover more than 90% of the Iranian population but have failed to organize the referral system and created favorable conditions for the ex-post moral hazard. Five hundred fifty people older than 15 years were randomly selected in five districts of Urmia city and completed the questionnaire to study the existence of Ex-post moral hazard in utilizing the high-consumption laboratory services (blood and urine tests). In this population-based cross-sectional study, utilization of the services in two groups of insured and uninsured people was analyzed using odds ratio statistics and logistic regression. The findings showed that being female (OR: 2.38) and having health insurance (OR: 2.03) played a very determinative role in obtaining selected laboratory services, and about 9% of the laboratory services provided were caused by ex-post moral hazard. The predicted size of ex-post moral hazard is significant, so its control requires modifying health insurance policies in determining the premium and cost-sharing schemes and controlling physicians' behavior as the principal applicants for these services.