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Original Articles
- Prevalence and Determinants of Catastrophic Healthcare Expenditures in Iran From 2013 to 2019
- Abdoreza mousavi, Farhad lotfi, Samira Alipour, Aliakbar Fazaeli, Mohsen Bayati
- J Prev Med Public Health. 2024;57(1):65-72. Published online November 25, 2023
- DOI: https://doi.org/10.3961/jpmph.23.291
- 804 View
- 68 Download
- 1 Crossref
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Abstract
Summary
PDF - 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. -
SummaryKey Message
• The aim of this study was to analyze the prevalence and determinants of catastrophic health expenditures (CHE) in Iran. • Catastrophic health expenditures (CHE) are used for monitoring financial protection within health systems. • The World Health Organization defines CHE as out-of-pocket payments for healthcare that exceed 40% of a household’s capacity to pay. • In Iran, the prevalence of CHE increased from 3.60% in 2013 to 3.95% in 2019. • Continuous monitoring of CHE and its determinants is essential for implementing effective strategies aimed at enhancing financial protection.Citations
Citations to this article as recorded by
- An analysis of financial protection and financing incidence of out-of-pocket health expenditures in Kazakhstan from 2018 to 2021
Askhat Shaltynov, Yulia Semenova, Madina Abenova, Assel Baibussinova, Ulzhan Jamedinova, Ayan Myssayev
Scientific Reports.2024;[Epub] CrossRef
- Effects of Air Pollution on Public and Private Health Expenditures in Iran: A Time Series Study (1972-2014)
- Pouran Raeissi, Touraj Harati-Khalilabad, Aziz Rezapour, Seyed Yaser Hashemi, Abdoreza Mousavi, Saeed Khodabakhshzadeh
- J Prev Med Public Health. 2018;51(3):140-147. Published online May 14, 2018
- DOI: https://doi.org/10.3961/jpmph.17.153
- 7,605 View
- 194 Download
- 16 Crossref
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Abstract
PDF
- Objectives
Environmental pollution is a negative consequence of the development process, and many countries are grappling with this phenomenon. As a developing country, Iran is not exempt from this rule, and Iran pays huge expenditures for the consequences of pollution. The aim of this study was to analyze the long- and short-run impact of air pollution, along with other health indicators, on private and public health expenditures.
Methods
This study was an applied and developmental study. Autoregressive distributed lag estimating models were used for the period of 1972 to 2014. In order to determine the co-integration between health expenditures and the infant mortality rate, fertility rate, per capita income, and pollution, we used the Wald test in Microfit version 4.1. We then used Eviews version 8 to evaluate the stationarity of the variables and to estimate the long- and short-run relationships.
Results
Long-run air pollution had a positive and significant effect on health expenditures, so that a 1.00% increase in the index of carbon dioxide led to an increase of 3.32% and 1.16% in public and private health expenditures, respectively. Air pollution also had a greater impact on health expenditures in the long term than in the short term.
Conclusions
The findings of this study indicate that among the factors affecting health expenditures, environmental quality and contaminants played the most important role. Therefore, in order to reduce the financial burden of health expenditures in Iran, it is essential to reduce air pollution by enacting and implementing laws that protect the environment. -
Summary
Citations
Citations to this article as recorded by- Evaluating the Role of GDPPer Capita, Air Pollution and Non‐Economic Factors in Determining Health Expenditure: Evidence from Asian Region Using Instrumental Variables Techniques
Samia Nasreen, Aviral Kumar Tiwari, Mehr‐un Nisa, Faryal Ishtiaq
Economic Papers: A journal of applied economics and policy.2024; 43(1): 63. CrossRef - Does climate change drive up government healthcare costs in the European Union?
Adela Socol, Horia Iuga, Dragoș Socol, Iulia Cristina Iuga
Frontiers in Environmental Science.2023;[Epub] CrossRef - An analysis of emission reduction strategy for light and heavy-duty vehicles pollutions in high spatial–temporal resolution and emission
Leila Khazini, Mina Jamshidi Kalajahi, Nadège Blond
Environmental Science and Pollution Research.2022; 29(16): 23419. CrossRef - Air pollution and economic growth under local government competition: Evidence from China, 2007–2016
Shurui Jiang, Xue Tan, Peiqi Hu, Yue Wang, Lei Shi, Zhong Ma, Genfa Lu
Journal of Cleaner Production.2022; 334: 130231. CrossRef - Theoretical Model and Actual Characteristics of Air Pollution Affecting Health Cost: A Review
Xiaocang Xu, Haoran Yang, Chang Li
International Journal of Environmental Research and Public Health.2022; 19(6): 3532. CrossRef - Health is Wealth: A Dynamic SUR Approach of Examining a Link Between Climate Changes and Human Health Expenditures
Muhammad Azam, Abdul Majid Awan
Social Indicators Research.2022; 163(2): 505. CrossRef - Impact of Environmental Quality on Healthcare Expenditures in Developing Countries: A Panel Data Approach
Asim Anwar, Shabir Hyder, Russell Bennett, Mustafa Younis
Healthcare.2022; 10(9): 1608. CrossRef - The impact of air pollution on urban residents’ health expenditure: spatial evidence from Yangtze River Delta, China
Han Sun, Zhihui Leng, Hengsong Zhao, Shan Ni, Chao Huang
Air Quality, Atmosphere & Health.2021; 14(3): 343. CrossRef - Association between health expenditures, economic growth and environmental pollution: Long‐run and causality analysis from Asian economies
Samia Nasreen
The International Journal of Health Planning and Management.2021; 36(3): 925. CrossRef - The relationship between renewable energy use and health expenditures in EU countries
Mahmut Unsal Sasmaz, Aysun Karamıklı, Ulas Akkucuk
The European Journal of Health Economics.2021; 22(7): 1129. CrossRef - Do renewable energy and health expenditures improve load capacity factor in the USA and Japan? A new approach to environmental issues
Ugur Korkut Pata
The European Journal of Health Economics.2021; 22(9): 1427. CrossRef - Development of Reduction Scenarios Based on Urban Emission Estimation and Dispersion of Exhaust Pollutants from Light Duty Public Transport: Case of Tabriz, Iran
Mina Jamshidi Kalajahi, Leila Khazini, Yousef Rashidi, Saeed Zeinali Heris
Emission Control Science and Technology.2020; 6(1): 86. CrossRef The Impact of Air Pollution on Healthcare Expenditure for Respiratory Diseases: Evidence from the People’s Republic of China
Lele Li, Tiantian Du, Chi Zhang
Risk Management and Healthcare Policy.2020; Volume 13: 1723. CrossRef- Are Air Pollution, Economic and Non-Economic Factors Associated with Per Capita Health Expenditures? Evidence from Emerging Economies
Muhammad Usman, Zhiqiang Ma, Muhammad Wasif Zafar, Abdul Haseeb, Rana Umair Ashraf
International Journal of Environmental Research and Public Health.2019; 16(11): 1967. CrossRef - Health impact and related cost of ambient air pollution in Tehran
Reza Bayat, Khosro Ashrafi, Majid Shafiepour Motlagh, Mohammad Sadegh Hassanvand, Rajabali Daroudi, Günther Fink, Nino Künzli
Environmental Research.2019; 176: 108547. CrossRef - Sağlık Harcamalarının Belirleyicileri Üzerine Bir Uygulama: Çevre Kirliliği ve Yönetişimin Etkilerinin İncelenmesi
Alper KARASOY, Gökhan DEMİRTAŞ
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