Document Type : Original Article
Authors
1 Professor, Healthcare Management, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
2 MSc Student, Healthcare Management, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
Abstract
Introduction: Direct cash payments are the principal sources of health care finance in most countries.
Health services may impose a regressive cost burden on households, especially in developing countries.
The purpose of this study was to calculate households encountered with catastrophic healthcare
expenditures in Qazvin, Iran.
Methods: The statistical society included 100 household equaled to 416 people. The data were collected
using self-administered questionnaire. The capacity to pay of households was calculated by two methods.
If the costs of household health were ≥ 40% of their capacity for payment, it would be considered as
catastrophic expenditures.
Results: According to the findings, the rate of confronting households with health catastrophic
expenditures had been estimated 24%, which dentistry services had the highest part in health catastrophic
expenditures.
Conclusion: Low capacity to pay families should be supported against these expenditures and more
financial aid should be provided for them.
Keywords
Switzerland: World Health Organization; 2000.
2. Knaul FM, Arreola-Ornelas H, Méndez-Carniado O, Bryson-Cahn C, Barofsky J, Maguire R, et al. Evidence is
good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico.
The Lancet 1918; 368(9549): 1828-41.
3. Haines A, Heath I, Smith R. Joining together to combat poverty. Everybody welcome and needed. BMJ 2000;
320(7226): 1-2.
4. O'Donnell OA, Wagstaff A. Analyzing Health Equity Using Household Survey Data: A Guide to Techniques and
Their Implementation. Washington, DC: World Bank Publications; 2008.
5. Jowett M. Theoretical Insights into the Development of Health Insurance in Low-income Countries. New York,
NY: University of York. Center for Health Economics; 2004.
6. World Health Organization. Macroeconomics and Health: Investing in Health for Economic Development:
Report. Geneva, Switzerland: World Health Organization; 2001.
7. OECD World Health Organization. DAC Guidelines and Reference Series Poverty and Health. Paris, France:
OECD Publishing; 2003.
8. Wagstaff A, van DE. Catastrophe and impoverishment in paying for health care: with applications to Vietnam
1993-1998. Health Econ 2003; 12(11): 921-34.
9. van DE, O'Donnell O, Rannan-Eliya RP, Somanathan A, Adhikari SR, Garg CC, et al. Catastrophic payments for
health care in Asia. Health Econ 2007; 16(11): 1159-84.
10.World Health Organization, Van Lerberghe W. The World Health Report 2008: Primary Health Care: Now More
Than Ever. Geneva, Switzerland: World Health Organization; 2008.
11.World Health Organization. The World Health Report 2006: Working Together for Health. Geneva, Switzerland:
World Health Organization; 2006.
12.Barros AJ, Bastos JL, Damaso AH. Catastrophic spending on health care in Brazil: private health insurance does
not seem to be the solution. Cad Saude Publica 2011; 27(Suppl 2): S254-S262. 13.Garg CC, Karan AK. Reducing out-of-pocket expenditures to reduce poverty: a disaggregated analysis at ruralurban
and state level in India. Health Policy Plan 2009; 24(2): 116-28.
14.Gotsadze G, Zoidze A, Rukhadze N. Household catastrophic health expenditure: evidence from Georgia and its
policy implications. BMC Health Serv Res 2009; 9: 69.
15.Xu K, Evans DB, Kawabata K, Zeramdini R, Klavus J, Murray CJ. Household catastrophic health expenditure: a
multicountry analysis. Lancet 2003; 362(9378): 111-7.
16. Filmer D, Hammer JS, Pritchett LH. Weak links in the chain II: a prescription for health policy in poor countries.
The World Bank Research Observer 2002; 17(1): 47-66.
17.Heijink R, Xu K, Saksena P, Evans D. Validity and comparability of out-of-pocket health expenditure from
household surveys: a review of the literature and current survey instruments. Geneva, Switzerland: World Health
Organization; 2011.
18. Statistical Center of Iran. Selected findings of the survey of energy carriers consumption in household sector in
urban areas. Tehran, Iran: Statistical Center of Iran; 2012 [Online]. 2012. Available from: URL:
http://www.amar.org.ir/Portals/0/Files/abstract/1390/ch_energy_90.pdf.
19.Kavosi Z, Rashidian A, Pourmalek F, Majdzadeh R, Pourreza A, Mohammad K, et al. Measuring household
exposure to catastrophic health care expenditures: a Longitudinal study in Zone 17 of Tehran. Hakim Res J 2009;
12(2): 38-47. [In Persian].
20.Karami M, Najafi F, Karami MB. Catastrophic health expenditures in Kermanshah, west of Iran: magnitude and
distribution. J Res Health Sci 2009; 9(2): 36-40.
21.Xu K, Evans DB, Carrin G, Aguilar-Rivera AM, Musgrove P, Evans T. Protecting households from catastrophic
health spending. Health Aff (Millwood) 2007; 26(4): 972-83.
22.Naga RH, Lamiraud K. Catastrophic health expenditure and household well-being [Online]. 2011; Available
from: URL: http://ideas.repec.org/p/hem/wpaper/0803.html/
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