Health inequalities and development plans in Iran; an analysis of the past three decades (1984–2010)

International Journal for Equity in Health

Gisselle Gallego⁴  Mojtaba Ghasemi²  Julia Driessen⁵  Antonio J Trujillo³  Hossein Zare¹ 

[1] Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran;Department of Economics, University of Siena, Piazza San Francesco, 7, Siena, Italy;Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, Maryland 21205, USA;Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia;Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street A614 Crabtree, Pittsburgh, PA 15261, USA

关键词: Out-of-pocket;    Gender inequalities;    Kakwani;    Development plans;    Gini;    Health inequalities;    Health services;    Inequality;   

Others  :  802251
DOI  :  10.1186/1475-9276-13-42

 received in 2013-10-11, accepted in 2014-05-06,  发布年份 2014

【 摘 要 】

Introduction

Reducing inequalities in health care is one of the main challenges in all countries. In Iran as in other oil-exporting upper middle income countries, we expected to witness fewer inequalities especially in the health sector with the increase in governmental revenues.

Methods

This study presents an inequalities assessment of health care expenditures in Iran. We used data from the Household Income and Expenditure Survey (HIES) in Iran from 1984–2010. The analysis included 308,735 urban and 342,532 rural households.

Results

The results suggest heightened inequality in health care expenditures in Iran over the past three decades, including an increase in the gap between urban and rural areas. Furthermore, inflation has affected the poor more than the rich. The Kakwani progressivity index in all years is positive, averaging 0.436 in rural and 0.470 in urban areas during the time period of analysis. Compared to inequality in income distribution over the last 30 years, health expenditures continuously show more inequality and progressivity over the same period of time.

Conclusions

According to the result of our study, during this period Iran introduced four National Development Plans (NDPs); however, the NDPs failed to provide sustainable strategies for reducing inequalities in health care expenditures. Policies that protect vulnerable groups should be prioritized.

【 授权许可】

   
2014 Zare et al.; licensee BioMed Central Ltd.

【 图 表 】

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