Demand for medical care in the urban areas of Iran: an empirical investigation

Kermani, Majid; Ghaderi, Hossein; Yousefi, Ayoub

doi:10.1002/hec.1308

Cited by 16 publications

(16 citation statements)

References 23 publications

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“…This finding is in accordance with those of other studies (Heikkila et al, 2014;Kermani et al, 2008;Sarma et al, 2012). One study showed that fee-for-service payment had a negative effect on physician willingness to participate.…”

Section: Discussionsupporting

confidence: 92%

Acceptability of the Urban Family Medicine Project among Physicians: A Cross-Sectional Study of Medical Offices, Iran

Kor

Rashidian

Hosseini

et al. 2016

GJHS

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Introduction: It is essential to organize private physicians in urban areas by developing urban family medicine in Iran. Acceptance of this project is currently low among physicians. The present research determined the factors affecting acceptability of the Urban Family Medicine Project among physicians working in the private sector of Mazandaran and Fars provinces in Iran.Methods: This descriptive-analytical and cross-sectional study was conducted in Mazandaran and Fars provinces. The target population was all physicians working in private offices in these regions. The sample size was calculated to be 860. The instrument contained 70 items that were modified in accordance with feedback from eight healthcare managers and a pilot sample of 50 physicians. Data was analyzed using the LISREL 8.80. Results:The response rate was 82.21% and acceptability was almost 50% for all domains. The fit indices of the structural model were the chi-square to degree-of-freedom (2.79), normalized fit index (0.98), non-normalized fit index (0.99), comparative fit index (0.99), and root mean square error of approximation (0.05). Training facilities had no significant direct effect on acceptability; however, workload had a direct negative effect on acceptability. Other factors had direct positive effects on acceptability. Conclusion:Specification of the factors relating to acceptance of the project among private physicians is required to develop the project in urban areas. It is essential to upgrade the payment system, remedy cultural barriers, decrease the workload, improve the scope of practice and working conditions, and improve collaboration between healthcare professionals.

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Section: Discussionsupporting

confidence: 92%

Acceptability of the Urban Family Medicine Project among Physicians: A Cross-Sectional Study of Medical Offices, Iran

Kor

Rashidian

Hosseini

et al. 2016

GJHS

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“…Since financing Iran's health system is mainly based on out of pocket payments and social insurance (12,13), the vertical equity of each of these financing methods was investigated as well. According to the results, the Gini coefficient had an average status in both urban and rural areas during the study period; of course, the index had a better status in the urban areas.…”

Section: Discussionmentioning

confidence: 99%

“…At first glance, the positivity of the concentration index for out-of-pocket payments may represent a higher contribution by wealthier households to health payments and confirm the equity in the payments. Nonetheless, in Iran, where the health system is mainly financed through out-of-pocket payments when using healthcare services (12,13), this index can represent the wealthy benefiting from the healthcare services. Thus, the lower deciles' neglecting to use the healthcare services might have decreased their out-of-pocket payments and, eventually, resulted in the positivity of the concentration index.…”

Section: Discussionmentioning

confidence: 99%

“…Between 1998 and 2001, the contributions by the public sector decreased from 52% to 38%, while those from the private sector increased from 48% to 60%. In addition, considering the lack of development in private insurance, most of the expenditures were paid for out of pocket (11)(12)(13). Other regional studies in various provinces of the country have revealed households' exposure to catastrophic health expenditures (14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

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Equity in Health Care Financing Among Iranian Households

et al. 2015

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Background: One of the main challenges of all health systems is achieving equity in healthcare financing. The Kakwani index is an equity index used to show how distant a financing source is from the proportional status. Objectives: The present study aimed to measure the equity of Iran's health system financing in rural and urban areas between 2001 and 2010 using the Kakwani index. Materials and Methods: This study analyzed secondary data for the years 2001 through 2010 in Iran. The data of annual household expenditures and an income survey conducted by the statistical center of Iran (SCI) were used in this study. In addition, out of pocket payments and health insurance premiums, as two sources of healthcare financing, were investigated regarding vertical equity. The T-test was used to test the dominance of the curves. Results: The Kakwani index was negative (regressive) for out of pocket payments among both rural and urban households (-0.168 in 2001 to -0.197 . The dominance test (T-test) showed the concentration curves of out of pocket payments in both areas dominated the Lorenz curve in all years, but the dominance test (T-test) for health insurance premium payments did not follow a regular trend during the study period. Conclusions: Due to the negativity of the Kakwani index for out-of-pocket payments, a great burden on the households can be predicted, and the progressivity of health insurance premium payments implies that expanding insurance coverage may lead to more equitable financing. Thus, the government should take the responsibility to expand the service and cost coverage of insurance plans and to develop policies that protect poor people.

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“…However, while people with diabetes are likely to incur significant direct non-healthcare costs [5], in the study by Esteghamati and colleagues [1] this cost is treated as an indirect cost. Fourth, although healthcare in Iran is subsidised by the government [9], the estimation of healthcare costs in the study appears to have been based on insurance and out-of-pocket expenditures, with no adjustment indicated for any disparity between prices and the real costs of healthcare interventions. Finally, the loss of economic productivity from attendants accompanying patients is not calculated: many attendants will be economically active and so not taking their lost productivity into account may underestimate the economic cost of diabetes.…”

mentioning

confidence: 99%