- Prevalence and Determinants of Catastrophic Healthcare Expenditures in Iran From 2013 to 2019
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Abdoreza mousavi, Farhad lotfi, Samira Alipour, Aliakbar Fazaeli, Mohsen Bayati
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J Prev Med Public Health. 2024;57(1):65-72. Published online November 25, 2023
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DOI: https://doi.org/10.3961/jpmph.23.291
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Abstract
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- Objectives
Protecting people against financial hardship caused by illness stands as a fundamental obligation within healthcare systems and constitutes a pivotal component in achieving universal health coverage. The objective of this study was to analyze the prevalence and determinants of catastrophic health expenditures (CHE) in Iran, over the period of 2013 to 2019.
Methods Data were obtained from 7 annual national surveys conducted between 2013 and 2019 on the income and expenditures of Iranian households. The prevalence of CHE was determined using a threshold of 40% of household capacity to pay for healthcare. A binary logistic regression model was used to identify the determinants influencing CHE.
Results The prevalence of CHE increased from 3.60% in 2013 to 3.95% in 2019. In all the years analyzed, the extent of CHE occurrence among rural populations exceeded that of urban populations. Living in an urban area, having a higher wealth index, possessing health insurance coverage, and having employed family members, an employed household head, and a literate household head are all associated with a reduced likelihood of CHE (p<0.05). Conversely, the use of dental, outpatient, and inpatient care, and the presence of elderly members in the household, are associated with an increased probability of facing CHE (p<0.05).
Conclusions Throughout the study period, CHE consistently exceeded the 1% threshold designated in the national development plan. Continuous monitoring of CHE and its determinants at both household and health system levels is essential for the implementation of effective strategies aimed at enhancing financial protection.
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Summary
Key Message
• The aim of this study was to analyze the prevalence and determinants of catastrophic health expenditures (CHE) in Iran.
• Catastrophic health expenditures (CHE) are used for monitoring financial protection within health systems.
• The World Health Organization defines CHE as out-of-pocket payments for healthcare that exceed 40% of a household’s capacity to pay.
• In Iran, the prevalence of CHE increased from 3.60% in 2013 to 3.95% in 2019.
• Continuous monitoring of CHE and its determinants is essential for implementing effective strategies aimed at enhancing financial protection.
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- An analysis of financial protection and financing incidence of out-of-pocket health expenditures in Kazakhstan from 2018 to 2021
Askhat Shaltynov, Yulia Semenova, Madina Abenova, Assel Baibussinova, Ulzhan Jamedinova, Ayan Myssayev Scientific Reports.2024;[Epub] CrossRef
- Effects of Air Pollution on Public and Private Health Expenditures in Iran: A Time Series Study (1972-2014)
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Pouran Raeissi, Touraj Harati-Khalilabad, Aziz Rezapour, Seyed Yaser Hashemi, Abdoreza Mousavi, Saeed Khodabakhshzadeh
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J Prev Med Public Health. 2018;51(3):140-147. Published online May 14, 2018
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DOI: https://doi.org/10.3961/jpmph.17.153
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7,628
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Abstract
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- Objectives
Environmental pollution is a negative consequence of the development process, and many countries are grappling with this phenomenon. As a developing country, Iran is not exempt from this rule, and Iran pays huge expenditures for the consequences of pollution. The aim of this study was to analyze the long- and short-run impact of air pollution, along with other health indicators, on private and public health expenditures.
Methods This study was an applied and developmental study. Autoregressive distributed lag estimating models were used for the period of 1972 to 2014. In order to determine the co-integration between health expenditures and the infant mortality rate, fertility rate, per capita income, and pollution, we used the Wald test in Microfit version 4.1. We then used Eviews version 8 to evaluate the stationarity of the variables and to estimate the long- and short-run relationships.
Results Long-run air pollution had a positive and significant effect on health expenditures, so that a 1.00% increase in the index of carbon dioxide led to an increase of 3.32% and 1.16% in public and private health expenditures, respectively. Air pollution also had a greater impact on health expenditures in the long term than in the short term.
Conclusions The findings of this study indicate that among the factors affecting health expenditures, environmental quality and contaminants played the most important role. Therefore, in order to reduce the financial burden of health expenditures in Iran, it is essential to reduce air pollution by enacting and implementing laws that protect the environment.
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