Socioeconomic inequality in catastrophic healthcare expenditures in Western Iran

Satar Rezaei, Mohammad Hajizadeh, Sina Ahmadi, Sadaf Sedghi, Bakhtiar Piroozi, Amjad Mohamadi-Bolbanabad and Enayatollah Homaie Rad ()

International Journal of Social Economics, 2019, vol. 46, issue 9, 1049-1060

Abstract: Purpose - Financial protection of households against catastrophic healthcare expenditure (CHE) is defined as one of the main goals in health systems. The purpose of this paper is to measure and decompose socioeconomic inequality in CHE among households in Kermanshah province, Western of Iran. Design/methodology/approach - This cross-sectional study was carried out among 1,188 households in 2017. Data were extracted from the Household Income and Expenditure Survey which is conducted by the Statistical Center of Iran. The CHE is defined as household healthcare expenditure greater than or equal to the 40 percent of household’s “capacity to pay.” The concentration curve and the Wagstaff (W) and Erreygers (E) indexes were used to illustrate and measure the extent of socioeconomic inequality in CHE. In addition, the authors decomposed theWandEindexes to identify the main determinants of socioeconomic inequality in CHE. Findings - The results indicated that the prevalence of CHE among households was 4.12 percent (95% confidence interval (CI): 3.13 to 5.42 percent). The estimated value of theWandEindexes were −0.2849 (95% CI: −0.4493 to −0.1205) and −0.0451 (95% CI: −0.0712 to −0.0190), respectively; suggesting the concentration of CHE prevalence among the poor households. Decomposition analyses indicated socioeconomic status as the most important factor contributing to the concentration of CHE among the poor. In contrast, health insurance coverage was found to increase the concentration of CHE among the rich in Iran. Originality/value - The current study demonstrated a higher concentration of CHE among the poor households in Kermanshah province. These results call for the government’s efforts to reduce healthcare expenditure among socioeconomically disadvantaged populations. Further studies are required to understand the mechanisms through which health insurance coverage increased the probability of CHE among rich in Kermanshah province.

Keywords: Decomposition analysis; Inequality; Concentration index; Catastrophic healthcare expenditure (search for similar items in EconPapers)
Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:eme:ijsepp:ijse-01-2019-0034

DOI: 10.1108/IJSE-01-2019-0034

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