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Impacts of Health Reform Plan in Iran on Health Payments Distributions and Catastrophic Expenditure

BACKGROUND: Health reform in Iran began in 2014, aimed at improving financing pattern of health services. We assessed the reform by changes in variables representing distribution of health payments and catastrophic expenditures. METHODS: Using data from households' income-expenditure survey, th...

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Autores principales: JOSHANI KHEIBARI, Morteza, ESMAEILI, Reza, KAZEMIAN, Mahmood
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tehran University of Medical Sciences 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908924/
https://www.ncbi.nlm.nih.gov/pubmed/31850264
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author JOSHANI KHEIBARI, Morteza
ESMAEILI, Reza
KAZEMIAN, Mahmood
author_facet JOSHANI KHEIBARI, Morteza
ESMAEILI, Reza
KAZEMIAN, Mahmood
author_sort JOSHANI KHEIBARI, Morteza
collection PubMed
description BACKGROUND: Health reform in Iran began in 2014, aimed at improving financing pattern of health services. We assessed the reform by changes in variables representing distribution of health payments and catastrophic expenditures. METHODS: Using data from households' income-expenditure survey, this study computed the financial variables, representing poverty line and households at poor state, household's catastrophic health expenditure, fairness in financial contribution (FFC) index, and household's impoverishment state, in the years 2010–2016, in urban and rural areas. The variables were computed by special software designed for this study, based on C-Sharp(C#) programming language, with yearly data on more than 38000 households, each with 1072 information sources. RESULTS: The food share-based poverty line after sharp rise in 2010–2013, in 2014–2016 raised slowly, and the average percent of households facing catastrophic health expenditure, after sharp rise in 2011–2013, left at 3.25 in 2014–2015 and raised to 3.45 in 2016. The average FFC index remained at 0.839 to 0.837 in 2013–2016. However, interestingly, the average percent of households impoverished after out-of-pocket payments improved from 1.36 to 0.912 in 2013–2016. CONCLUSION: In three years of health reform, the major impact of reform was considerable improvements in the rate of the impoverished after out-of-pocket payments. The reform had limited impacts on the rates of households facing catastrophic health expenditure, and on FFC indexes, for the rural and urban residents.
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spelling pubmed-69089242019-12-17 Impacts of Health Reform Plan in Iran on Health Payments Distributions and Catastrophic Expenditure JOSHANI KHEIBARI, Morteza ESMAEILI, Reza KAZEMIAN, Mahmood Iran J Public Health Original Article BACKGROUND: Health reform in Iran began in 2014, aimed at improving financing pattern of health services. We assessed the reform by changes in variables representing distribution of health payments and catastrophic expenditures. METHODS: Using data from households' income-expenditure survey, this study computed the financial variables, representing poverty line and households at poor state, household's catastrophic health expenditure, fairness in financial contribution (FFC) index, and household's impoverishment state, in the years 2010–2016, in urban and rural areas. The variables were computed by special software designed for this study, based on C-Sharp(C#) programming language, with yearly data on more than 38000 households, each with 1072 information sources. RESULTS: The food share-based poverty line after sharp rise in 2010–2013, in 2014–2016 raised slowly, and the average percent of households facing catastrophic health expenditure, after sharp rise in 2011–2013, left at 3.25 in 2014–2015 and raised to 3.45 in 2016. The average FFC index remained at 0.839 to 0.837 in 2013–2016. However, interestingly, the average percent of households impoverished after out-of-pocket payments improved from 1.36 to 0.912 in 2013–2016. CONCLUSION: In three years of health reform, the major impact of reform was considerable improvements in the rate of the impoverished after out-of-pocket payments. The reform had limited impacts on the rates of households facing catastrophic health expenditure, and on FFC indexes, for the rural and urban residents. Tehran University of Medical Sciences 2019-10 /pmc/articles/PMC6908924/ /pubmed/31850264 Text en Copyright© Iranian Public Health Association & Tehran University of Medical Sciences http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
JOSHANI KHEIBARI, Morteza
ESMAEILI, Reza
KAZEMIAN, Mahmood
Impacts of Health Reform Plan in Iran on Health Payments Distributions and Catastrophic Expenditure
title Impacts of Health Reform Plan in Iran on Health Payments Distributions and Catastrophic Expenditure
title_full Impacts of Health Reform Plan in Iran on Health Payments Distributions and Catastrophic Expenditure
title_fullStr Impacts of Health Reform Plan in Iran on Health Payments Distributions and Catastrophic Expenditure
title_full_unstemmed Impacts of Health Reform Plan in Iran on Health Payments Distributions and Catastrophic Expenditure
title_short Impacts of Health Reform Plan in Iran on Health Payments Distributions and Catastrophic Expenditure
title_sort impacts of health reform plan in iran on health payments distributions and catastrophic expenditure
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6908924/
https://www.ncbi.nlm.nih.gov/pubmed/31850264
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