Moradi Tayebeh, Naghdi Seyran, Brown Heather, Ghiasvand Hesam, Mobinizadeh Mohammadreza
Iran Health Insurance Organization (IHIO), Tehran, Iran.
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
Int J Health Plann Manage. 2018 Mar 24. doi: 10.1002/hpm.2517.
Lack of well-designed healthcare financing mechanisms and high level of out-of-pocket payments in Iran over the last decades led to implementing Health Transformation Plan, in 2014. This study aims to decompose inequality in financial protection of Iranian households after the implementation of the Health Transformation Plan.
The data of Statistical Center of Iran (SCI) Survey on Rural and Urban Households Income-Expenditure in 2015 to 2016 were used. The headcount ratio of catastrophic health expenditures was calculated. The corrected concentration index was estimated. The role of contributors on inequality in the exposure to catastrophic health expenditures among poor and nonpoor households was calculated using Farelie's model.
The headcount ratio of the exposure to catastrophic health expenditures in urban and rural households was 2.5% (2.43% - 2.64%) and 3.6% (3.48% - 3.76%), respectively. The difference in households' income levels was the main contributor in explaining the inequality in facing catastrophic health expenditures between poor and nonpoor households. [Correction added on 02 June 2018, after first online publication: The "Results" section of the Abstract of the published article has been correctly updated on this version.] CONCLUSION: Even after implementing the HTP, the headcount ratios of catastrophic health expenditure are still considerable. The results show that income is the greatest determinant of inequality in facing catastrophic health expenditure and in urban households.
在过去几十年里，伊朗缺乏精心设计的医疗融资机制，且自付费用水平较高，这促使该国在2014年实施了《健康转型计划》。本研究旨在剖析《健康转型计划》实施后伊朗家庭在财务保护方面的不平等状况。
使用了伊朗统计中心2015年至2016年城乡家庭收支调查的数据。计算了灾难性医疗支出的发生率。估算了校正后的集中指数。采用法雷利模型计算了贫困和非贫困家庭中导致灾难性医疗支出不平等的因素。
城乡家庭中灾难性医疗支出发生率分别为2.5%（2.43% - 2.64%）和3.6%（3.48% - 3.76%）。家庭收入水平差异是解释贫困和非贫困家庭面临灾难性医疗支出不平等的主要因素。[首次在线发表后于2018年6月2日添加的更正：已在此版本中正确更新了已发表文章摘要的“结果”部分。]结论：即使在实施《健康转型计划》之后，灾难性医疗支出的发生率仍然相当可观。结果表明，收入是面临灾难性医疗支出不平等以及城市家庭中不平等的最大决定因素。
