Background and purpose: Diagnostic services are very important as inherent part of modern medical care about 70% of medical diagnoses are made based on their results. This study aimed to evaluate the effect of household income, geographical access, out of pocket, physician's visits and hospitalization of Iranian Social Security Organization-insured patients on the utilization of laboratory and imaging services. Materials and methods: In analytical study, the Iranian Social Security Organization database in each province in the period of 1998-2011 was searched. Study population included 24 million people covered by this organization ferred to the direct and indirect treatment sectors for laboratory and imaging services over these years. To estimate the model the fixed effects logarithmic regression via the Eviews software was used. Results: The following factors had a significant effect on the utilization of laboratory and imaging facilities: geographical access to the laboratory (β = 0.31) and imaging (β = 0.50) facilities, household income on the utilization of the laboratory (β = 0.24) and imaging (β = 0.43) services, outpatient visits on the utilization of the laboratory (β = 0.56) and imaging (β = 0.43) services, and inpatient services on the utilization of the laboratory (β = 0.35) and imaging (β = 0.51) services. Also, amount of out of pocket for using the mentioned services and referral burden of inpatient and outpatient for direct treatment had no significant relation with utilization of the services. Conclusion: If policymakers exclusively pay attention to the out of pocket, they cannot provide the appropriate utilization of services. Sometimes, to set the used utilizations, the channels such as commands of general practitioners or specialist and/or geographical access are often forgotten.

Keywords: Social security organization, out of pocket, laboratory, imaging, utilization

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