Economic Profile of Iranian Rehabilitation Services: 2002-2017

Objective: The role of the service sector in general and healthcare services in particular have been promoting in Iran’s economy. The implementation of the Health System Transformation Plan and the injection of new financial resources into this sector have raised concerns about the health system function. Thus, this is the first attempt to estimate and evaluate the share of rehabilitation services in the Iranian economic and health systems. Materials & Methods: The study utilized longitudinal trend analysis using the National Health Accounts data during 2002-2015. National Health Accounts, through input-output tables, breaks down the share of different sources of financing for different functions of the health system. According to this method, both the share of rehabilitation services in Iran’s economy and the financing sources of these activities have been calculated and compared to other countries. Data on Iran's National Health Accounts has been collected from the Statistical Center of Iran. International data is collected from the World Health Organization's National Health Accounts and the databases of the Organization for Economic Cooperation and Development member countries. Results: Rehabilitation services expenditures in Iran reached to 69.8 million Dollar (1USD=42500 IRR) which accounts for 0.02 percent of its Gross Domestic Product (GDP). The share of rehabilitation expenditures in total health expenditures was at its highest level (3.07%) in 2007 and has declined in the following years. This share reached about 0.22% in 2017, which was the lowest rate in 16 years. Comparing the share of rehabilitation in Iran's economy with different countries shows that the prominence of this sector in Iran’s GDP is very low compared not only to developed countries, but also to other developing countries. Tunisia, Tonga, and Moldova are similar countries to Iran, in terms of the share of rehabilitation activities in their economy; but there is a lower prevalence of disability in these countries than in Iran. Breaking down the financial resources of rehabilitation expenditure reveals that households’ out-of-pocket payments (37.6%) and government (17.7%) had highest and lowest financial contribution for the activities, respectively. What seems truly noteworthy is that the government funds for rehabilitation services were about 65 percent before the implementation of the Health System Transformation Plan. These figures are more noticeable when we see that, more than 26.7% of total health spending in Iran was borne by the government in 2015. Conclusion: Inaccessibility of people with disabilities to healthcare services is a very serious issue in the world. The rehabilitation services expenditures have always been mentioned as one of the most important barriers of accessing to these services.  Following the implementation of the Health Transformation Plan, the share of rehabilitation activities in Iran’s health market has been shrunk.