EVALUATION OF THE COST OF MEDICAL CARE IN THE SOCIAL SECURITY ORGANIZATION IN RESPECT TO FAMILY SIZE

Abstract

This study was carried out to discover: 1) Whether provision of medical care and social welfare affected the size of the family among laborers. 2) Compare laborers family size with that of the total population of Isfahan. 3) Since Social Security receives its premium on the basis of salary rather than the number of dependents, then what is the cost of medical care for groups of single and married persons with various family sizes. Out of 70,171 laborers, about 1,158 records were selected on a random basis. The sample consisted of 144 singles (group I), 131 married persons with no children (group II), 601 married persons with 1-3 children (group III), and 282 persons with 4 or more children (group IV). The hospital days, periods of illnesses, indemnity, medical care costs were investigated for each group. It was found that: a) group IV used the outpatient clinic more than all the other groups, b)almost always group I had occupied hospital beds more often than group II, and group IV used the benefits of hospital care more than other groups, c) the medical care utilization was found to be highest among group IV), d) the amount of indemnity received by laborers was more in groups I and IV than in others, and e) the KAP survey results showed that laborers acknowledged receiving pensions, believed that children mortality had reduced, knew about family planning programs, around one third claimed that their last child was unwanted, expected children to help them in later life and knew some children were apparently unwanted. It is recommended that 1) premium payments should be based on the number of dependents rather than on salary alone, 2) large families are not economically feasible since their needs are excessive and their contribution is less, at present, proper family planning and preventive programs, especially tubal ligations, should be implemented, 3) the pension allocated for families should be raised to eliminate the need for the benefits received from children in old-age.