Evidence map›Paper›PMID 38409010›Full record

ReviewBMC health services research2024

Exploring the driving forces and scenario analysis for catastrophic and impoverishing health expenditures in Iran.

Maryam Hedayati, Mohammadreza Maleki, Iravan Masoudi Asl, Ali Akbar Fazaeli, Salime Goharinezhad

Open access · goldAbstract readReview
In one paragraph

Review in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Maryam HedayatiDepartment of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, No. 6, Rashid Yasemi St. Vali -e Asr Ave, P.O Box: 1996713883, Tehran, Iran.ORCID http://orcid.org/0000-0002-5425-5514
Mohammadreza MalekiDepartment of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, No. 6, Rashid Yasemi St. Vali -e Asr Ave, P.O Box: 1996713883, Tehran, Iran. maleki.mr@iums.ac.ir.ORCID http://orcid.org/0000-0002-2708-5310
Iravan Masoudi AslDepartment of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, No. 6, Rashid Yasemi St. Vali -e Asr Ave, P.O Box: 1996713883, Tehran, Iran.ORCID http://orcid.org/0000-0002-0389-9571
Ali Akbar FazaeliDepartment of Health Management, Policy and Economics, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0000-0002-6667-0344
Salime GoharinezhadPreventive Medicine and Public Health Research Center, Psychosocial Research Institute, Iran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0000-0001-8565-3606
Iran University of Medical Sciences · IRTehran University of Medical Sciences · IR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe extent of healthcare expenditure within households stands as a crucial indicator in low and middle-income countries (LMICs). When out-of-pocket healthcare expenses surpass household income or become unduly burdensome, it serves as a significant socio-economic alarm, resulting in a reduced quality of life, a phenomenon referred to as 'catastrophic health expenditure (CHE).' Multiple factors can contribute to the occurrence of CHE. The study's objective was to identify the key uncertainties and driving forces influencing CHE to develop scenarios in Iran on the horizon of 2030.

methodsThis study was conducted between December 2021 and January 2023, data were collected through a literature review, and experts' opinions were gathered via questionnaires, interviews, and expert panels. The statistical population included experts in the fields of health policy, health economics, and futures studies. Scenario Wizard software and MICMAC analysis were employed for data analysis, providing valuable insights into potential future scenarios of health expenditures in Iran.

resultsBased on the results of the scoping review and semi-structured interview, 65 key factors in the fields of economics, politics, technology, social, and environmental were identified. The findings of the MICMAC analysis presented 10 key variables. Finally, six main scenario spaces are depicted using Scenario Wizard. These scenarios included catastrophic cost crises, sanction relief, selective information access, technological ambiguity, induced demand management, and incremental reforms.

conclusionsEach of the six drawn scenarios provides images of the future of health expenditure in Iranian households on the horizon of 2030. The worst-case scenario from all scenarios was scenario one, with the most probable and critical features to derive Iran's health expenditures. The current study is a valuable addition to the literature depicting the key drivers that all developing nations can consider to decrease exposing households to catastrophic and impoverishing health expenditures.

Indexed as

Health ExpendituresQuality of LifeCatastrophic IllnessHealth PolicyHumansIranCatastrophic health care expenditureCross-impact analysisDriving forcesFutures studiesImpoverishingScenario based planningUncertainty

Identifiers

PMID38409010
PMCPMC10898180
OpenAlexW4392169151

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.