Measuring Financial Protection in Hospitalized Patients after the Health Sector Evolution Plan in Iran

Reshadat, Sohyla; Najafi, Farid; Karami-Matin, Behzad; Soofi, Moslem; Barfar, Eshagh; Gilan, Nader Rajabi; Ghasemi, Seyyed Ramin

doi:10.5812/jhealthscope.63163

Cited by 5 publications

(9 citation statements)

References 29 publications

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“…Based on the study results, as supported by other studies (10,13,14,18,25,26), there was an inverse relationship between facing CHE and increasing rank of economic quintiles among households. However, the findings of a study by Somkotra and Lagrada in 2009 disclosed that following the implementation of UHC in Thailand, CHE shifted from poor to rich households (24).…”

Section: Discussionsupporting

confidence: 80%

“…Our findings showed that the mean OOP health expenditure for participants was $ 124. Two previous studies conducted after the HTP reported this figure as $ 24 and $ 39 (10,14). However, these figures are lower than what a study reported before the HTP (13).…”

Section: Discussionmentioning

confidence: 61%

“…Moreover, the results of a study carried out in Sistan and Baluchistan province, Iran, after the HTP implementation indicated that the goals of Iranian development plans have not been attained in this context (7). However, some studies showed that the percentage of exposure to CHE declined in Iran after the HTP (10,11,21). Moreover, studies by Limwattananon et al (20) and Yardim et al (18) in Thailand and Turkey, respectively, showed that the rate of households facing CHE decreased after domestic health reform plans.…”

Section: Discussionmentioning

confidence: 99%

“…Studies in Iran have reported that the incidence of CHE ranges from 1.97 to 15.3% at the national level, 3.6 to 24 % at the regional level, and 4.8 to 72.5% among specific groups (8)(9)(10)(11)(12)(13)(14). There is, therefore, still a gap between the goal of the Fifth Economic, Social, and Cultural Development Plan of Iran, which is to reduce the rate of households facing CHE to less than 1% (15).…”

Section: Introductionmentioning

confidence: 99%

“…Obviously, the presence of a disease, especially a chronic and costly disease, is an important factor in increasing the number of households facing CHE. Although numerous studies have addressed the CHE in Iran and other countries (6,(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), many of them have concentrated on the general population rather than vulnerable groups and no previous study has investigated the CHE among households with mental disorders patients.…”

Section: Introductionmentioning

confidence: 99%

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Catastrophic Health Expenditure in Households with Severe Mental Disorders Patients: Evidence After Iran's Health Transformation Plan

et al. 2019

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Background:The high cost of mental health services can be a great barrier to accessing healthcare for patients with mental disorders. Objectives: The present study aimed to measure the catastrophic health expenditure (CHE) for households with severe mental disorders (SMDs) patients. Methods: A cross-sectional study was conducted among 400 households with SMDs patients who referred to four psychiatric university centers located in Tehran for outpatient services from July 2017 to March 2018. We consecutively selected 100 participants from each hospital. Data were collected using the World Health Survey questionnaire through interviews. The method considered by the WHO was used to measure the CHE and a forced-entry logistic regression technique was applied to assess factors affecting the CHE using STATA version 14.0 software. Results: The results showed that 25.75% of the households with SMDs patients faced CHE. There was also a significant relationship between households facing CHE and variables including the age of the household head (40 -59 years; OR: 0.283, P value = 0.049), education status of the household head (university; OR: 0.075, P value = 0.002), utilization of dental (OR: 12.38, P value = 0.000), rehabilitation (OR: 6.99, P value = 0.012), and medication (OR: 3.17, P value = 0.049) services, and the household expenditures quintile (the fifth quintile; OR: 0.111 P value = 0.000). Conclusions:It is suggested that the Health Transformation Plan financially covers outpatient healthcare services more sufficiently, especially for mental disorders.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Catastrophic Health Expenditure in Households with Severe Mental Disorders Patients: Evidence After Iran's Health Transformation Plan

et al. 2019

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Can Health Insurance Protect Against Catastrophic Health Expenditures in Iran? A Systematic Review and Meta‐Analysis

Soofi¹,

Arab‐Zozani²,

Kazemi-Karyani³

et al. 2021

World Med & Health Policy

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The results of previous Iranian studies on the protective effect of health insurance on catastrophic health expenditures (CHE) are inconsistent. Therefore, the aim of this meta‐analysis was to summarize all existent evidence. We searched international and Iranian scientific databases for relevant literature. Using a Mantel–Haenszel random‐effects model, the pooled odds ratios (OR) were calculated. Subgroup meta‐analyses were performed considering the type of insurance and study population. The pooled OR for the protective effect of health insurance risk on facing CHE was 0.93 (95% confidence interval [CI], 0.68–1.28). The protective effect of the two types of insurance was statistically insignificant. Health insurance does not effectively provide financial protection against CHE in Iran. Expanding the prepayment mechanism and integrating health insurance funds can be good strategies in protecting people from CHE. More attention should be paid to the design of health insurance benefit package to cover chronic diseases.

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Economic burden of cardiovascular diseases before and after Iran’s health transformation plan: evidence from a referral hospital of Iran

Alipour

Zandian

Yazdi‐Feyzabadi

et al. 2021

Cost Eff Resour Alloc

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Background Different countries have set different policies to control and decrease the costs of cardiovascular diseases (CVDs). Iran was aiming to reduce the economic burden of different disease by a recent reform from named as health transformation plan (HTP). This study aimed to examine the economic burden of CVDs before and after of HTP. Methods This cross-sectional study was conducted on 600 patients with CVDs, who were randomly selected from a specialized cardiovascular hospital in the north-west of Iran. Direct and indirect costs of CVDs were calculated using the cost of illness and human capital approaches. Data were collected using a researcher-made checklist obtained from several sources including structured interviews, the Statistical Center of Iran, Iran’s Ministry of Cooperatives, Labor, and Social Welfare, the central bank of Iran, and the data of global burden of disease obtained from the Institute for Health Metrics and Evaluation to estimate direct and mortality costs. All costs were calculated in Iranian Rials (IRR). Results Total costs of CVDs were about 5571 and 6700 billion IRR before and after the HTP, respectively. More than 62% of the total costs of CVDs accounted for premature death before (64.89%) and after (62.01%) the HTP. The total hospitalization costs of CVDs was significantly increased after the HTP (p = 0.038). In both times, surgical services and visiting had the highest and lowest share of hospitalization costs, respectively. The OOP expenditure decreased significantly and reached from 54.2 to 36.7%. All hospitalization costs, except patients’ OOP expenditure, were significantly increased after the HTP about 1.3 times. Direct non-medical costs reached from 2.4 to 3.3 billion before and after the HTP, respectively. Conclusion Economic burden of CVDs increased in the north-west of Iran after the HTP due to the increase of all direct and indirect costs, except the OOP expenditure. Non-allocation of defined resources, which coincided with the international and national political and economic challenges in Iran, led to unsustainable resources of the HTP. So, no results of this study can be attributed solely to the HTP. Therefore, more detailed studies should be carried out on the reasons for the significant increase in CVDs costs in the region.

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Measuring Financial Protection in Hospitalized Patients after the Health Sector Evolution Plan in Iran

Cited by 5 publications

References 29 publications

Catastrophic Health Expenditure in Households with Severe Mental Disorders Patients: Evidence After Iran's Health Transformation Plan

Catastrophic Health Expenditure in Households with Severe Mental Disorders Patients: Evidence After Iran's Health Transformation Plan

Can Health Insurance Protect Against Catastrophic Health Expenditures in Iran? A Systematic Review and Meta‐Analysis

Economic burden of cardiovascular diseases before and after Iran’s health transformation plan: evidence from a referral hospital of Iran

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