文章基本信息

标题：Homaie Rad, Yazdi-Feyzabad, Yousefzadeh-Chabok, Afkar, and Naghibzadeh: Pros and cons of the health transformation program in Iran: evidence from financial outcomes at the household level
其他标题：Pros and cons of the health transformation program in Iran: evidence from financial outcomes at the household level
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作者：Enayatollah Homaie Rad ; Vahid Yazdi-Feyzabad ; Shahrokh Yousefzadeh-Chabok 等
期刊名称：Epidemiology and Health
印刷版ISSN：2092-7193
出版年度：2017
卷号：39
DOI：10.4178/epih.e2017029
语种：English
出版社：Taehan P'ibu Kwahakhoe
其他摘要：OBJECTIVES The health transformation program was a recent reform in the health system of Iran that was implemented in early 2014. Some of the program’s important goals were to improve the equity of payments and to reduce out-of-pocket (OOP) payments and catastrophic health expenditures (CHE). In this study, these goals were evaluated using a before-and-after analysis. METHODS Data on household income and expenditures in Guilan Province were gathered for the years 2013 and 2015. OOP payments for outpatient, inpatient, and drug services were calculated, and the results were compared using the propensity score matching technique after adjusting for confounding variables. Concentration indices and curves were added to quantify changes in inequity before and after the reform. The incidence of catastrophic expenditures was then calculated. RESULTS Overall and outpatient service OOP payments increased by approximately 10 dollars, while for other types of services, no significant changes were found. Inequity and utilization of services did not change after the reform. However, a significant reduction was observed in CHE incidence (5.75 to 3.82%). CONCLUSIONS The reform was successful in decreasing the incidence of CHE, but not in reducing the monetary amount of OOP payments or affecting the frequency of health service utilization.
其他关键词：Health care reform ; Health expenditures ; Health equity ; Financial statements ; Catastrophic illnesses ; Iran’s health transformation program