Repository of Research and Investigative Information

Repository of Research and Investigative Information

Kurdistan University of Medical Sciences

Catastrophic health expenditure after the implementation of health sector evolution plan: A case study in the west of Iran

(2016) Catastrophic health expenditure after the implementation of health sector evolution plan: A case study in the west of Iran. International Journal of Health Policy and Management.

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Abstract

Background: One of the main objectives of health systems is the financial protection against out-of-pocket (OOP) health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP) has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percentage of households facing catastrophic health expenditures (CHE) after the implementation of HSEP and the factors that determine CHE. Methods: A total of 663 households were selected through a cluster sampling based on the census framework of Sanandaj Health Center in July 2015. Data were gathered using face-to-face interviews based on the household section of the World Health Survey questionnaire. In this study, according to the World Health Organization (WHO) definition, if household health expenditures were equal to or more than 40 of the household capacity to pay, household was considered to be facing CHE. The determinants of CHE were analyzed using logistic regression model. Results: The rates of households facing CHE were 4.8. The key determinants of CHE were household economic status, presence of elderly or disabled members in the household and utilization of inpatient or rehabilitation services. Conclusion: The comparison of our findings and those of other studies carried out using a methodology comparable with ours in different parts of Iran before the implementation of HSEP suggests that the implementation of recent reforms has reduced CHE at the household level. Utilization of inpatient and rehabilitation services, the presence of elderly or disabled members in the household and the low economic status of the household would increase the likelihood of facing CHE. These variables should be considered by health policy-makers in order to review and revise content of recent reform, thus financially protecting public against CHE. © 2016 by Kerman University of Medical Sciences.

Item Type: Article
Keywords: adolescent; adult; aged; child; cluster analysis; cross-sectional study; economics; female; financial management; health care cost; health care policy; human; interview; Iran; male; middle aged; preschool child; socioeconomics; statistics and numerical data; terminal disease; young adult, Adolescent; Adult; Aged; Catastrophic Illness; Child; Child, Preschool; Cluster Analysis; Cross-Sectional Studies; Female; Financing, Personal; Health Expenditures; Health Policy; Humans; Interviews as Topic; Iran; Male; Middle Aged; Socioeconomic Factors; Young Adult
Page Range: pp. 417-423
Journal or Publication Title: International Journal of Health Policy and Management
Volume: 5
Number: 7
Publisher: Kerman University of Medical Sciences
Identification Number: 10.15171/ijhpm.2016.31
ISSN: 23225939
Depositing User: مهندس جمال محمودپور
URI: http://eprints.muk.ac.ir/id/eprint/660

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