ArticleClinicoEconomics and outcomes research : CEOR2020
Explaining Socioeconomic Inequality Differences in Catastrophic Health Expenditure Between Urban and Rural Areas of Iran After Health Transformation Plan Implementation.
Article in ClinicoEconomics and outcomes research : CEOR, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Catastrophic health expenditure and associated factors in low-, lower-middle and upper-middle-income countries: systematic review and meta-analysis.Global health action · 2026Pooled it
- Decomposing socioeconomic inequalities in contraceptive use among Kurdish women: a cross-sectional analysis of the ravansar cohort study.BMC public health · 2025Article
- Decomposing socioeconomic inequality in household out of pocket health expenditures in Pakistan (2010-11-2018-19).BMC health services research · 2024Article
- The Effect of Iran Health Transformation Plan on Equity in Health Financing: A Systematic Review.Iranian journal of public health · 2023Review
- Socioeconomic inequality in informal payments for health services among Iranian households: a national pooled study.BMC public health · 2023Article
- The Variations in Catastrophic and Impoverishing Health Expenditures, and Its Determinants in Iran: A Scoping Review.Medical journal of the Islamic Republic of Iran · 2023Article
- Financial risk protection from out-of-pocket health spending in low- and middle-income countries: a scoping review of the literature.Health research policy and systems · 2022Article
- The influence of the National Health Insurance scheme of the Lao People's Democratic Republic on healthcare access and catastrophic health expenditures for patients with chronic renal disease, and the possibility of integrating organ transplantation into the health financing system.Health research policy and systems · 2022Article
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveEnsuring fair financial contribution is one of the main goals of the Health Transformation Plan (HTP) of Iran. This study aims to estimate socioeconomic inequality differences in catastrophic health expenditure (CHE) between urban and rural areas of Iran after the implementation of the HTP during 2017. MATERIALS AND
methodsData from a representative survey of households' income and xpenditure from the Iran Statistical Center (ISC) were used for the analysis. We applied the World Health Organization (WHO) cut-off of 40% payment for CHE, and Wagstaff's normalized concentration index (
resultsThe overall incidence of CHE among Iranian households during the year 2017 was 3.32% with a standard deviation (SD) of 17.91%, and the mean (SD) levels of CHE in rural and urban areas of Iran were 4.37% (20.45%) and 2.97% (16.99%), respectively. The aggregate socioeconomic status (SES)-related inequality in CHE was significantly (
conclusionOur findings revealed a significant pro-rich inequality in CHE. Also, some variables, such as sex and region, made different contributions in rural and urban areas. However, SES, itself, made the highest contribution in both areas and explained the greatest share of difference in inequality between the two areas. This issue calls for revision of the HTP to further address the risk of CHE and socioeconomic disparity among Iranian households, especially those with lowSES.
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