پديد آورندگان :
يزدي فيض آبادي، وحيد نويسنده دانشكده مديريت و اطلاع رساني پزشكي - دانشگاه علوم پزشكي ايران yazdi feyz abadi, vahid , بهرام پور، مینا نويسنده MSc in Health Economics, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Bahrampour, M , رشیدیان، آرش نويسنده Professor in Health Policy and Management, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Rashidian, A , حقدوست، علی اكبر نويسنده Professor in Epidemiology, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Haghdoost, AA , ابوالحلاج، مسعود نويسنده Abolhalaj, M , نجفی، بهزاد نويسنده Assistant Professor in Health Economics, School of Management and Medical Informatics,Tehran University of Medical Sciences, Tehran, Iran Najafi, B , اكبری جور، محمد رضا نويسنده MSc in Health Services Management, Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Akbari Javar, MR , مهرالحسنی، محمد حسین نويسنده Associate Professor in Health Services Management, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman Iran Mehrolhassani, MH
كليدواژه :
Catastrophic Health Expenditures (CHE) , iranian Provinces , حفاظت مالي , پراكندگي , مخارج كمرشكن سلامت , disparity , Financial protection , استان‌هاي ايران
چكيده لاتين :
Background and Objectives: Catastrophic health expenditure (CHE) is a key indicator for measuring householdsʹ financial protection in the health system. This study was conducted to measure the incidence and intensity of CHE in Iranian provinces 2008-2014.
Methods: When the out-of-pocket (OOP) spending of each household amounts to at least 40% of the householdʹs capacity to pay, it is called a catastrophe. The incidence of CHE in Iranian provinces was estimated using the data obtained from household-expenditure-and-income-surveys. The intensity was calculated as the average extent to which OOPs exceeded the 40% threshold. Descriptive statistics and Mann-WhitneyU test were used for data analysis. The index of disparity(ID) was also calculated for geographical disparities across the provinces.
Results: On average, the lowest and highest CHE incidence and intensity were seen in Fars and South Khorasan provinces respectively. However, the highest and lowest rate for CHE households that actually experienced catastrophe at the 40% threshold belonged to Fars and Kurdistan provinces. The incidence of CHE in rural was more than urban areas. ID of CHE incidence for targeted amount was high and had no constant trend.
Conclusion: CHE incidence had a remarkable difference in different provinces and in the rural area compared to the urban area. Due to the importance of this index in promoting health financial protection, like indexes such as OOP, its distribution in rural and urban areas as well as in different provinces is considerable. It requires a structured format to identify the disadvantaged and low-income groups and provide financial-support and insurance for them.
