برآورد عادلانه بودن هزينه خدمات سلامتي در منطقه تحت پوشش پايگاه تحقيقات جمعيتي گرگان

Assessing of equality on health care cost in Gorganʹs Population Laboratory Study

Background and Objective: In all of world. a portion of household income expends on health care cost. Amount and distribution of the proportion indicate financial burden of health care in the societies. WHO believes that one of the main determinants in health system efficiency is fairness of financial contribution. This study aimed distribution pattern of urban householdsʹ income, health expenditure by cost types and measuring of equality on health care costs in the Gorgan district. Materials and Methods: In order to establishe the Population Laboratory, this cross-sectional study assessed 1014 household in the Gorgan health posts (No 4 and 8) on January 2003. Health insurance status, monthly household income and monthly health care cost gathered through interviewing with the husbandmans. Results: Health insurance coverage was 67% in highest and 44% in lowest income deciles (P<0.05). Medain and mean of assessed householdsʹ income and household health care cost were 1,200,000 Rls, (1,669,669±187,300 Rls) and 80,000 Rls, (281,530±95,124 Rls) respectively. Mean of median of out of pocket proportion health care cost per householdʹs income was 0.57+0.03 and 0.66 respectively. 13% of total income expended health care cost through out of pocket. This proportion in highest and lowest income decile was 7% and 28% (P<0.05). Gini coefficient of health care cost and out of pocket cost per total household income were 0.22 and 0.18 respectively. Conclusion: Low income households expended almost 40% of their income in order to purchasing of health care, in comparison to richest households, they spent 9% of total income. Instead of, additive development of health insurance systems and complementary insurance mechanisms, a half of health care cost in the population spend by out of pocket. According to WHO standards of health system performance, revising health insurance system and payment mechanisms are mandatory.