Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Prevalence and Determinants of Catastrophic Healthcare Expenditures in Iran From 2013 to 2019

  • Abdoreza Mousavi (Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences) ;
  • Farhad Lotfi (National Center for Health Insurance Research) ;
  • Samira Alipour (Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences) ;
  • Aliakbar Fazaeli (Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences) ;
  • Mohsen Bayati (Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences)
  • Received : 2023.06.23
  • Accepted : 2023.11.13
  • Published : 2024.01.31
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Abstract

Objectives: Protecting people against financial hardship caused by illness stands as a fundamental obligation within healthcare systems and constitutes a pivotal component in achieving universal health coverage. The objective of this study was to analyze the prevalence and determinants of catastrophic health expenditures (CHE) in Iran, over the period of 2013 to 2019. Methods: Data were obtained from 7 annual national surveys conducted between 2013 and 2019 on the income and expenditures of Iranian households. The prevalence of CHE was determined using a threshold of 40% of household capacity to pay for healthcare. A binary logistic regression model was used to identify the determinants influencing CHE. Results: The prevalence of CHE increased from 3.60% in 2013 to 3.95% in 2019. In all the years analyzed, the extent of CHE occurrence among rural populations exceeded that of urban populations. Living in an urban area, having a higher wealth index, possessing health insurance coverage, and having employed family members, an employed household head, and a literate household head are all associated with a reduced likelihood of CHE (p<0.05). Conversely, the use of dental, outpatient, and inpatient care, and the presence of elderly members in the household, are associated with an increased probability of facing CHE (p<0.05). Conclusions: Throughout the study period, CHE consistently exceeded the 1% threshold designated in the national development plan. Continuous monitoring of CHE and its determinants at both household and health system levels is essential for the implementation of effective strategies aimed at enhancing financial protection.

Keywords

Acknowledgement

We would also like to thank Shiraz University of Medical Sciences for financial support.

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