نوع مقاله : مقاله پژوهشی
نویسندگان
1 استادیار اقتصاد سلامت، گروه بهداشت عمومی، دانشکده بهداشت، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران
2 دانشیار گروه مدیریت، سیاستگذاری و اقتصاد سلامت، دانشکده بهداشت، دانشگاه علوم پزشکی تهران، تهران، ایران
3 استادیار روانپزشکی گروه داخلی، دانشکده پزشکی بیمارستان واسعی دانشگاه علوم پزشکی سبزوار
چکیده
زمینه و هدف: هزینه کردن بخش زیادی از منابع خانوار برای دریافت خدمات سلامت میتواند سطح استاندارد زندگی را در کوتاهمدت و بلندمدت تهدید کند. در این پژوهش میزان مشارکت مالی خانوارها در بهرهمندی از خدمات سلامت در استان خراسان رضوی در سال 1402 موردبررسی قرارگرفته است.
مواد و روشها: این مطالعه بهصورت مقطعی به بررسی هزینههای بهداشتی درمانی در سال 1402 پرداخته است. دادههای مورداستفاده، از طرح سرشماری هزینه و درآمد خانوار مرکز آمار ایران استخراجشده است. از میان مدلهای اقتصادسنجی، مدل لاجیــت انتخاب و در نرمافزارهای اقتصادسنجی Stata14 تحلیل شد.
یافتهها: نتایج مطالعه نشان میدهد که 1/3 درصد از خانوارهای استان خراسان رضوی در سال 1402 با هزینههای بسیار سنگین سلامت روبرو شدهاند که میان احتمال مواجهه با این هزینهها و محل سکونت، سواد، شغل و تأهل سرپرست خانوار ارتباط معناداری دیده شد.
نتیجهگیری: توزیع نامناسب خدمات سلامت، توزیع ناعادلانه درآمد و ثروت میان مشاغل و شرایط نامناسب اجتماعی و اقتصادی میتوانند بر بروز هزینههای کمرشکن سلامت مؤثر واقع گردند.
تازه های تحقیق
https://scholar.google.com/citations?user=AtALJH4AAAAJ&hl=en
https://pubmed.ncbi.nlm.nih.gov/?term=Alireza+ghorbani&sort=fauth
https://scholar.google.com/citations?user=8M75hksAAAAJ&hl=en
https://pubmed.ncbi.nlm.nih.gov/?term=Ali+akbar+Fazaeli&sort=fauth
https://scholar.google.com/citations?user=gaNbVs0AAAAJ&hl=en&oi=ao
https://pubmed.ncbi.nlm.nih.gov/?term=Abdoreza+Mousavi&sort=fauth
https://scholar.google.com/citations?view_op=list_works&hl=en&authuser=2&user=tLAMSp0AAAAJ
https://pubmed.ncbi.nlm.nih.gov/?term=Mohammad+Reza+Shegarf+Nakhaie&sort=fauth
کلیدواژهها
عنوان مقاله [English]
Catastrophic Health Expenditures and Their Determinants: A Study in Razavi Khorasan, Iran
نویسندگان [English]
- Alireza Ghorbani 1
- Ali Akbar Fazaeli 2
- Mohammad Reza Shegarf Nakhaie 3
1 Assistant Professor of Health Economics, Department of Public Health, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
2 Associate Professor of Health Economics School of Public Health Tehran University of Medical Sciences
3 Assistant Professor of Psychiatry Department of Internal Medicine, School of Medicine Vasei Hospital Sabzevar University of Medical Sciences
چکیده [English]
Introduction: Devoting a large portion of household resources to health care services can make true threats 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 Razavi Khorasan Province in 2023.
Materials and 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. Among the common econometric models, the logit model was employed and the data were then analyzed using the Stata 14 software.
Results: The results also showed that 3.1% of the households faced catastrophic cost. Upon examining the factors, significant relationship was further observed between the probability of exposure to CHE and living in rural areas, insurance, education and employee’s 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.
کلیدواژهها [English]
- Catastrophic health expenditures
- Out of Pocket
- Logit Model
- Household
- Yazdi-Feyzabadi V, Bahrampour M, Rashidian A, Haghdoost A-A, Akbari Javar M, Mehrolhassani MH. Prevalence and intensity of catastrophic health care expenditures in Iran from 2008 to 2015: a study on Iranian household income and expenditure survey. International Journal for Equity in Health. 2018;17(1):44.DOI.org/10.1186/s12939-018-0743-y.
- Morteza JK, Reza E, Mahmood K. Impacts of Health Reform Plan in Iran on Health Payments Distributions and Catastrophic Expenditure. Iranian Journal of Public Health. 2019;48(10).DOI.org/10.18502/ijph.v48i10.3494.
- Ahangar A, Ahmadi AM, Mozayani A, FarajiDizaji S. Key Health Financing Policies with Approach Risk-Sharing to Promote Health Systems in Poor and Developing Countries; Africa and Eastern Mediterranean (WHO) Regions. Iranian Journal of Health Education and Health Promotion. 2018;6(2):200-2.10.30699/acadpub.ijhehp.6.2.r200.
- Sato R. Catastrophic health expenditure and its determinants among Nigerian households. International journal of health economics and management. 2022;22(4):459-70.10.1007/s10754-022-09323-y.
- Abodi Z, Moradi G, Moradi Y, Bolbanabad AM, Hoorsan H. Assessing Catastrophic Health Expenditure among Iraqi Households: A Cross-Sectional Study. Iran J Public Health. 2025;54(6):1291-9.10.18502/ijph.v54i6.18907.
- Ghoddoosinejad J, Jannati A, Gholipour K, Baghban Baghestan E. Households encountering with catastrophic health expenditures in Ferdows, Iran. The Journal of the Egyptian Public Health Association. 2014;89(2):81-4.10.1097/01.epx.0000451789.21421.61.
- Hedayati M, Masoudi Asl I, Maleki M, Fazaeli AA, Goharinezhad S. The Variations in Catastrophic and Impoverishing Health Expenditures, and Its Determinants in Iran: A Scoping Review. Med J Islam Repub Iran. 2023;37:44.10.47176/mjiri.37.44.
- Garcia-Diaz R, Prasad Sapkota V, Flores G. Persistency of catastrophic out-of-pocket health expenditures: Measurement with evidence from three African countries - Malawi, Tanzania, and Uganda. Social Science & Medicine. 2024;357:117156.https://doi.org/10.1016/j.socscimed.2024.117156.
- Ghiasvand H, Mohamadi E, Olyaeemanesh A, Kiani MM, Armoon B, Takian A. Health equity in Iran: A systematic review. Med J Islam Repub Iran. 2021;35:51.10.47176/mjiri.35.51.
- 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):17.10.1186/s12962-020-00212-0.
- 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;46(9):1049-60.10.1108/ijse-01-2019-0034.
- amin E, sabermahani A, nejati M. Influence of socioeconomic factors associated with per capita household health expenditure in Iran provinces: years 1981 to 2011. North Khorasan University of Medical Sciences. 2016;8(1):17-31.10.29252/jnkums.8.1.17.
- Iran SCo. Household Income and Expenditure Survey 2015. Tehran: Statistical Center of Iran; 2015.
- Gheinali Z, Moshiri E, Ebrahimi Tavani M, Haghi M, Gharibi F. Catastrophic health expenditures in hospitalized patients with delta variant of COVID-19: A cross-sectional study. Health promotion perspectives. 2023;13(1):68-76.10.34172/hpp.2023.09.
- Motaghi S, Amini Milani M, Keshavarz M, Zabeti M, Fathizadeh A. Investigating the Factors Affecting Catastrophic Costs With Emphasis on the Role of Insurance. Iranian Journal of Health Insurance. 2022;5(1):52-9.journal.ihio.gov.ir/article-1-206.
- Amery H, Jafari A, Panahi M. Determining the Rate of Catastrophic Health Expenditure and Its Influential Factors on Families in Yazd Province. Journal of Health Administration. 2013;16(52):51-60.
- Hossein Panahi, Ali Janati, Mohammadreza Narimani, Ahmad Assadzadeh, Parviz Mohammadzadeh, Amineh Naderi. Catastrophic expenditures for hospitalized patients in Tabriz, Iran. Payesh (Health Monitor) Journal. 2014;13(6):655-63.
- Amaya-Lara JL. Catastrophic expenditure due to out-of-pocket health payments and its determinants in Colombian households. International Journal for Equity in Health. 2016;15(1):182.10.1186/s12939-016-0472-z.
- Liu C, Liu ZM, Nicholas S, Wang J. Trends and determinants of catastrophic health expenditure in China 2010-2018: a national panel data analysis. BMC Health Serv Res. 2021;21(1):526.10.1186/s12913-021-06533-x.
- Nekoeimoghadam M, Akbari-Javar M, Amiresmaili M, Baneshi M, Ganjavai S. Households Exposure to Catastrophic Health Expenditures and the Affecting Factors in Kerman Province, Iran. 2. 2013;1(2):101-90.
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