ABSTRACT
To study some direct fees paid by a household of a hospitalized patient during the treatment at secondary or tertiary care hospitals.The study was conducted using cross-sectional design. The data was collected from 6 specialized clinical centers, 7 hospitals of provincial and regional diagnostic and treatments centers, and 6 district hospitals using the data of 1335 in-patients hospitalized during 2012-2013. The in- patients’ medical histories were processed using descriptive research methods by using specially designed cards to register the costs for medications and medical equipment. In addition, the questionnaire was used to collect the data on direct and indirect costs associated with hospitalization paid by individuals. Statistical data was analyzed using SPSS 21.0 software. 96% (1282) of total hospitalized patients were covered by health insurance. However, 28.4% of them paid for their drug treatment out-of-pocket. 62% of in-patients who paid for their own medicines responded that the medicines were written in their medical history but the hospitals were out of stock and therefore did not provide them to the patients. 3% of in-patients who paid for their medicines were reimbursed the costs of medicines. When comparing the informal costs associated with a hospital stay to the total household income, 23% of respondents said that those expenditures were high. While 54% of total costs spent by hospitals on diagnosis and treatment of in-patients were used for medicines, the in-patients’ out-of-pocket expenditures were higher in secondary care hospitals.Due to drug supply in secondary and tertiary care hospitals is insufficient to meet the needs for drug treatment; in-patients are required to spend a part of their household income to pay for drug treatment during their hospital stay.