Equity in Out-of-Pocket Payments for Healthcare Service Delivery in Urban and Rural Households: Evidence from Iran
عنوان مقاله: Equity in Out-of-Pocket Payments for Healthcare Service Delivery in Urban and Rural Households: Evidence from Iran
شناسه ملی مقاله: JR_IJHLS-7-4_004
منتشر شده در در سال 1400
شناسه ملی مقاله: JR_IJHLS-7-4_004
منتشر شده در در سال 1400
مشخصات نویسندگان مقاله:
Bahman Ahadinezhad - Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
Omid Khosravizadeh - Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
Ahad Alizadeh - Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
Zahra Nejatifar - Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
خلاصه مقاله:
Bahman Ahadinezhad - Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
Omid Khosravizadeh - Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
Ahad Alizadeh - Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
Zahra Nejatifar - Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
Background: Out-of-pocket payments for medical services may undermine access to medical services and equity in healthcare
financing.
Objectives: The present study aimed to determine the distribution of the burden of out-of-pocket payments for healthcare services
among the households in Qazvin province, Iran.
Methods: This descriptive-analytical study was conducted on the urban and rural households in Qazvin province, Iran during ۲۰۱۹
- ۲۰۲۰. Data were obtained from the Statistics Center of Iran (۲۰۱۹ - ۲۰۲۰). The optimal sample size was calculated to be ۹۹۲ households,
and the households were selected via three-stage random cluster sampling. Data were collected using a valid questionnaire
and via face-to-face interviews with the household owners. The fair financial contribution index (FFCI), concentration index, and
Kakwani index were estimated in the Stata software.
Results: The estimated parameters indicated that during the study period (March ۲۱, ۲۰۱۹-March ۲۰, ۲۰۲۰), the FFCI value of the
rural and urban households was ۰.۷۸۲ and ۰.۸۵۴, respectively. The out-of-pocket payment concentration index based on income
rank was estimated at ۰.۱۸۸ in rural households (P < ۰.۰۵) and ۰.۰۳۱ in the urban households. In addition, the Kakwani index of the
urban and rural households was calculated to be -۰.۱۶۵ and -۰.۸۴, respectively.
Conclusions: According to the results, out-of-pocket payments were unequally distributed among the households in Qazvin
province in ۲۰۱۹ - ۲۰۲۰. These payments were mostly concentrated on the ۵th - ۷th deciles of urban households. On the other hand,
the out-of-pocket payments during the study period were regressive. To promote financial equity, Qazvin health policymakers must
run payment exemptions for low-income groups and also expand the medical insurance coverage and universal coverage of healthcare
services.
کلمات کلیدی: Equity in Financing, Out-of-Pocket, Health Expenses, Concentration Index, Kakwani Index, Fair Financial Contribution
Index
صفحه اختصاصی مقاله و دریافت فایل کامل: https://civilica.com/doc/1700690/