Health Policy and Management Department, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, Maryland 21205, USA.
Int J Equity Health. 2014 May 27;13:42. doi: 10.1186/1475-9276-13-42.
Reducing inequalities in health care is one of the main challenges in all countries. In Iran as in other oil-exporting upper middle income countries, we expected to witness fewer inequalities especially in the health sector with the increase in governmental revenues.
This study presents an inequalities assessment of health care expenditures in Iran. We used data from the Household Income and Expenditure Survey (HIES) in Iran from 1984-2010. The analysis included 308,735 urban and 342,532 rural households.
The results suggest heightened inequality in health care expenditures in Iran over the past three decades, including an increase in the gap between urban and rural areas. Furthermore, inflation has affected the poor more than the rich. The Kakwani progressivity index in all years is positive, averaging 0.436 in rural and 0.470 in urban areas during the time period of analysis. Compared to inequality in income distribution over the last 30 years, health expenditures continuously show more inequality and progressivity over the same period of time.
According to the result of our study, during this period Iran introduced four National Development Plans (NDPs); however, the NDPs failed to provide sustainable strategies for reducing inequalities in health care expenditures. Policies that protect vulnerable groups should be prioritized.
在所有国家，减少医疗保健方面的不平等都是主要挑战之一。在伊朗和其他石油出口的中上收入国家，我们预计随着政府收入的增加，不平等现象特别是在卫生部门会减少。
本研究评估了伊朗医疗保健支出方面的不平等。我们使用了 1984 年至 2010 年伊朗家庭收入和支出调查（HIES）的数据。该分析包括 308735 户城市家庭和 342532 户农村家庭。
研究结果表明，在过去三十年中，伊朗的医疗保健支出不平等程度加剧，包括城乡差距扩大。此外，通货膨胀对穷人的影响大于富人。在所有年份，Kakwani 累进指数均为正，在分析期间农村地区平均为 0.436，城市地区平均为 0.470。与过去 30 年的收入分配不平等相比，在同一时期，医疗支出的不平等和累进性持续增加。
根据我们的研究结果，在此期间，伊朗推出了四个国家发展计划（NDPs）；然而，NDPs 未能为减少医疗保健支出方面的不平等提供可持续战略。应优先考虑保护弱势群体的政策。
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