Journal of Health Sciences & Surveillance System

Determinants of Catastrophic Health Expenditures: A Study in Hamedan, Iran

Document Type : Original Article

Authors

Maryam Fakhrzad 1
Ali Akbar Fazaeli 2
Yadollah Hamidi 3

1 Department of Health Management and Economics, School of Public Health, Hamadan university of Medical Sciences, Hamadan, Iran

2 Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hmadan, Iran

https://doi.org/10.30476/jhsss.2021.93369.1444
Abstract
Background: Catastrophic health expenditure (CHE) has been explained as a growth in spending for health care services that exceeds 40% of total household income. Therefore, devoting a large portion of household resources to health care services can greatly threaten to standards of living in the short and long term. The present study was an attempt to evaluate the financial contribution of Iranian households in health care services system in Hamadan Province in 2017.
Methods: This cross-sectional study reflected on spending for health care services. For this purpose, the data were extracted from the household expenditure statistics published in the database of the Statistical Center of Iran. Accordingly, among the common econometric models associated with the subject matter, the logit model was employed, and the data were then analyzed using the Stata 14 software.
Results: The study findings revealed that 8.9% of the total household costs had been allocated to health care services. The results also showed that 3.5% of the households faced catastrophic cost among all the studied households. Upon examining the factors, significant relationship was further observed between the probability of exposure to CHE and living in rural areas, income decile group, number of employees, and marital status in the households concerned.
Conclusion: It was concluded that poor distribution of health care services, unequal distribution of income and wealth among jobs, as well as socioeconomic conditions could influence CHE. Therefore, there is a need to plan and develop policies for better access to health care services.

Keywords

Out-of-pocket
Health equity
Health care costs
Catastrophic
  1. Yousefi Nayer M, Fazaeli AA, Hamidi Y. Hospital efficiency measurement in the west of Iran: data envelopment analysis and econometric approach. Cost Effectiveness and Resource Allocation. 2022;20(1):5. doi: 10.1186/s12962-022-00341-8.
  2. Hamidi Y, Najafi L, Vatankhah S, Afkar A. The effect of performance appraisal results on the personnels motivation and job promotion. Australian Journal of Basic and Applied Sciences. 2010;4(9):4178-83.
  3. Hamidi Y, Barati M. Communication skills of heads of departments: verbal, listening, and feedback skills. 2011.
  4. Doshmangir L, Yousefi M, Hasanpoor E, Eshtiagh B, Haghparast-Bidgoli H. Determinants of catastrophic health expenditures in Iran: a systematic review and meta-analysis. Cost Effectiveness and Resource Allocation. 2020;18:1-21. doi: 10.1186/s12962-020-00212-0.
  5. Niasti F, Fazaeli AA, Hamidi Y, Viaynchi A. Applying ABC system for calculating cost price of hospital services case study: Beheshti hospital of Hamadan. Clinical epidemiology and global health. 2019;7(3):496-9. doi: 10.1016/j.cegh.2019.06.001.
  6. Ravangard R, Jalali FS, Bayati M, Palmer AJ, Jafari A, Bastani P. Household catastrophic health expenditure and its effective factors: a case of Iran. Cost Effectiveness and Resource Allocation. 2021;19(1):1-8. doi: 10.1186/s12962-021-00315-2.
  7. Wang X, White L. X, Chen.(2015)“. Big data research for the knowledge economy: past, present, and future,” Industrial Management & Data Systems.115(9). doi: 10.1108/IMDS-09-2015-0388.
  8. Fazaeli AA, Fazaeli AA, Hamidi Y, Moeini B, Valinejadi A. Analysis of iranian household financial participation in the health system: decomposition of the concentration index approach. Koomesh. 2018:358-68.
  9. Kavosi Z, Delavari H, Keshtkaran A, Setoudehzadeh F. Catastrophic health expenditures and coping strategies in households with cancer patients in Shiraz Namazi hospital. 2014.
  10. Yazdi Feyzabadi V, Bahrampour M, Rashidian A, Haghdoost A, Abolhallaje M, Najafi B, et al. Incidence and intensity of catastrophic health expenditures in Iranian provinces; 2008-2014. Iranian Journal of Epidemiology. 2017;12:40-54.
  11. Piroozi B, Zarei B, Ghaderi B, Safari H, Moradi G, Rezaei S, et al. Catastrophic health expenditure and its determinants in households with gastrointestinal cancer patients: evidence from new health system reform in Iran. International Journal of Human Rights in Healthcare. 2019. doi: 10.1108/IJHRH-01-2019-0008.
  12. Mohamadi E, Manesh AO, Takian A, Majdzadeh R, Lotfi FH, Sharafi H, et al. Technical efficiency in health production: A comparison between Iran and other upper middle-income countries. Health Policy and Technology. 2020;9(3):335-47. doi: 10.1016/j.hlpt.2020.06.007.
  13. Fazaeli AA, Ghaderi H, Salehi M, Fazaeli AR. Health care expenditure and GDP in oil exporting countries: evidence from OPEC data, 1995-2012. Global journal of health science. 2016;8(2):93.
  14. Edoka I, McPake B, Ensor T, Amara R, Edem-Hotah J. Changes in catastrophic health expenditure in post-conflict Sierra Leone: an Oaxaca-blinder decomposition analysis. International journal for equity in health. 2017;16(1):1-15. doi: 10.1186/s12939-017-0661-4.
  15. Haghdoost A, Dehnavieh R, Mehrolhssan MH, Abolhallaje M, Fazaeli AA, Ramezanian M. Future Financing Scenarios for Iran’s Healthcare System. Archives of Iranian Medicine. 2022;25(2):85-90. doi: 34172/aim.2022.14.
  16. Aryankhesal A, Etemadi M, Mohseni M, Azami-Aghdash S, Nakhaei M. Catastrophic health expenditure in Iran: a review a.rticle. Iranian journal of public health. 2018;47(2):166. PMCID: PMC5810379, PMID: 29445626.
  17. Mehrara M, Fazaeli AA. Health finance equity in Iran: an analysis of household survey data (1382-1386). Journal of health administration. 2010;13(40):51-62.
  18. Ahmadi R, Shafiei M, Ameri H, Askari R, Fallahzadeh H. Catastrophic Health Expenditure before and after of the Implementation of Health Sector Evolution Plan in Iran. INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2021;58. doi: 10.1177/00469580211050210.
  19. Mariolis A, Mihas C, Alevizos A, Mariolis-Sapsakos T, Marayiannis K, Papathanasiou M, et al. Comparison of primary health care services between urban and rural settings after the introduction of the first urban health centre in Vyronas, Greece. BMC Health Services Research. 2008;8(1):1-13. doi: 10.1186/1472-6963-8-124.
  20. Bagheri Lankarani K, Ghahramani S, Zakeri M, Joulaei H. Lessons learned from national health accounts in Iran: highlighted evidence for policymakers. Shiraz E-Medical Journal. 2015;16(4).
  21. Fazaeli AA, Seyedin H, Moghaddam AV, Delavari A, Salimzadeh H, Varmazyar H, et al. Fairness of financial contribution in Iranian health system: Trend analysis of national household income and expenditure, 2003-2010. Global journal of health science. 2015;7(5):260. doi: 5539/gjhs.v7n5p260, PMCID: PMC4803859, PMID: 26156920.
  22. Fazaeli AA, Hadian M, Rezapour A, Fazaeli AA. Assessing the distribution of household financial contribution to health system: a case study of Iran. Glob J Health Sci. 2016;8(10):233. doi: 10.5539/gjhs.v8n10p233.
  23. Kavosi Z, Rashidian A, Pourreza A, Majdzadeh R, Pourmalek F, Hosseinpour AR, et al. Inequality in household catastrophic health care expenditure in a low-income society of Iran. Health policy and planning. 2012;27(7):613-23. doi: 10.1093/heapol/czs001.
  24. Kavousi Z, Rashidian A, Pourmalek F, Majdzadeh S, POURREZA AG, Mohammad K, et al. Measuring household exposure to catastrophic health care expenditures: a Longitudinal study in Zone 17 of Tehran. 2009.
  25. Rezaei S, Hajizadeh M, Ahmadi S, Sedghi S, Piroozi B, Mohamadi-Bolbanabad A, et al. Socioeconomic inequality in catastrophic healthcare expenditures in Western Iran: a decomposition analysis. International Journal of Social Economics. 2019. doi: 10.1108/IJSE-01-2019-0034.
  26. Rezaei S, Hajizadeh M, Khosravipour M, Khosravi F, Rezaeian S. Socioeconomic inequalities in poor health-related quality of life in Kermanshah, Western Iran: A decomposition analysis. Journal of research in health sciences. 2018;18(1):405. PMCID: PMC7204413.
  27. Kimani DN, Mugo MG, Kioko UM. Catastrophic health expenditures and impoverishment in Kenya. European Scientific Journal. 2016;12(15). doi: 10.19044/esj.2016.v12n15p434.
  28. Hatam N, Heidari Orejlu P, Jafari A, Kavosi Z. Catastrophic healthcare expenditures of hospitalized patients in the hospitals of Shiraz in 2013. Shiraz E-Medical Journal. 2015;16(5).  doi: 17795/semj22231.
Journal of Health Sciences & Surveillance System
Volume 11, Issue 2
Spring 2023
Pages 302-307

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