inequity in household's capacity to pay and health payments in tehran-iran-2013

نویسندگان

aziz rezapour department of health economics, school of health management and information sciences& health management and economics research center &center of excellence in health management and economics, iran university of medical sciences. tehran, iran.سازمان اصلی تایید شده: دانشگاه علوم پزشکی ایران (iran university of medical sciences)

farbod ebadifard azar department of health education and promotion, school of health &health management and economics research center, iran university of medical sciences, tehran, iran.سازمان اصلی تایید شده: دانشگاه علوم پزشکی ایران (iran university of medical sciences)

saber azami aghdash school of health management and information sciences, iran university of medical sciences, tehran, iran.سازمان اصلی تایید شده: دانشگاه علوم پزشکی ایران (iran university of medical sciences)

asghar tanoomand department of microbiology, faculty of medical sciences, maragheh university of medical sciences, maragheh, iran.سازمان اصلی تایید شده: دانشگاه علوم پزشکی مراغه (maragheh university of medical sciences)

چکیده

background: health inequalitymonitoring especially in health care financing field is very important. hence, this study tends to assess the inequality in household's capacity to pay and out-of-pocket health carepaymentsin tehran metropolis. methods: this cross-sectional study was performed in 2013.thestudy population was selected by stratified cluster sampling, and they constitute the typical households living in tehran (2200 households). the required data were collected through questionnaires and analyzed using excel and stata v.11. concentration index on inequality wasused for measuring inequality status in capacity to pay and household payments for health care expenses and also the concentration index for out-of-pocket payments and capacity to pay was used to determine the extent of inequality. the recall period for inpatient care was one year and 1 month for outpatient. results: the average of out-of-pocket payments for receiving the outpatient services was determined to be 44.33us$ and for each inpatient1861.11 us$. concentration index for household's out-of-pocket payments for inpatient health care, out-of-pocket payments for outpatient health care and health prepayments werecalculated 0.13, -0.10 and -0.11, respectively. also, concentration index in household’s capacity to pay was estimated to be 0.11whichindicatedinequality to the benefit of the rich. the households used financing strategies like savings, borrowing or lending to pay their health care expenditures. conclusion: according to this study, the poor spend a greater portion of their capacity to pay for outpatient and inpatient health care costs and prepayment, in comparison to the rich. thus, supporting the vulnerable groups of the society to decrease out-of-pocket payments and increasing the household’s capacity to pay through government support in order to improve the household economic potential, must be considered very important.

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عنوان ژورنال:
medical journal of islamic republic of iran

جلد ۲۹، شماره ۱، صفحات ۶۷۴-۶۸۴

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