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Original Article
- Prevalence and Determinants of Catastrophic Healthcare Expenditures in Iran From 2013 to 2019
- Abdoreza mousavi, Farhad lotfi, Samira Alipour, Aliakbar Fazaeli, Mohsen Bayati
- J Prev Med Public Health. 2024;57(1):65-72. Published online November 25, 2023
- DOI: https://doi.org/10.3961/jpmph.23.291
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- 303 Download
- 2 Web of Science
- 3 Crossref
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Abstract
Summary
PDF - 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. -
SummaryKey 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.Citations
Citations to this article as recorded by
- Determinants of Catastrophic Health Expenditure and Its Impact on Poverty in Deltaic Country: Evidence From Bangladesh
Md Abdur Rouf Sarkar, Md Jahid Ebn Jalal, Shijun Ding, Ismat Ara Begum, Bo Yang, Mohammad Jahangir Alam
Sustainable Development.2025;[Epub] CrossRef - Analysis of national health accounts in Iran (2002–2020)
Abdoreza Mousavi, Mahdi Mokhtari-Payam, Aliakbar Fazaeli, Mohammad Bakhtiari Aliabad
Payesh (Health Monitor) Journal.2025; 24(1): 7. CrossRef - 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
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