Hajizadeh, Mohammad and Connelly, Luke B. (2009): Equity of health care financing in Iran.
Download (990kB) | Preview
This study presents the rst analyses of the equity of health care financing in Iran. Kakwani Progressivity Indices (KPIs) and concentration indices (CIs) are estimated using ten national household expenditure surveys, which were conducted in Iran from 1995/96 to 2004/05. The indices are used to analyze the progressivity of two sources of health care financing: health insurance premium payments and consumer co-payments (and the sum of these), for Iran as a whole, and for rural and urban areas of Iran, separately. The results suggest that health insurance premium payments became more progressive over the study period; however the KPIs for consumer co-payments suggest that these are still mildly regressive or slightly progressive, depending upon whether household income or expenditure data are used to generate the indices. Interestingly, the Urban Inpatient Insurance Scheme (UIIS), which was introduced by the Iranian government in 2000 to extend insurance to uninsured urban dwellers, appears to have had a regressive impact on health care nancing, which is contrary to expectations. This result sounds a cautionary note about the potential for public programs to crowd out private sector, charitable activity, which was prevalent in Iran prior to the introduction of the UIIS.
|Item Type:||MPRA Paper|
|Original Title:||Equity of health care financing in Iran|
|Keywords:||Equity, Health care nancing, Kakwani progressivity index, Iran|
|Subjects:||D - Microeconomics > D3 - Distribution > D31 - Personal Income, Wealth, and Their Distributions
D - Microeconomics > D6 - Welfare Economics > D63 - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
P - Economic Systems > P4 - Other Economic Systems > P43 - Public Economics ; Financial Economics
I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy ; Regulation ; Public Health
|Depositing User:||Luke B. Connelly|
|Date Deposited:||16. Apr 2009 23:47|
|Last Modified:||20. Feb 2013 20:40|
Deaton, A. and Grosh, M. 2000. Consumption. In: Grosh, M. and Glewwe, P. (eds) Designing Household Questionnaires for Developing Countries: Lessons from Fifteen Years of the Living Standards Measurement Study. World Bank: Washington, pp.91-133.
Gerdtham, U.G., Sundberg, G. 1998. Redistributive effects of Swedish health care nance. International Journal of Health Planning and Management 13: 289-306.
Lairson, D.R., Hindson, P., Hauquitz, A. 1995. Equity of health care in Australia. Social Science & Medicine 41: 475-482.
Management and Planning Organization of Iran (2004). Iran Fourth Socio-Economic Development Act , Government of Iran: Tehran.
Mooney, G. 1986. Economics, Medicine, and Health Care. Wheatsheaf: Brighton.
Murray, C.J.L., Knaul, F., Musgrove, P., Xu, K., Kawabata, K. 2000. Dening and Measuring Fairness in Financial Contribution to the Health System. Global Programme on Evidence for Health Policy Discussion Paper Series: No. 24. World Health Organization: Geneva.
O'Donnell, O., van Doorslaer, E., Rannan-Eliya, R.P., Somanathan, A., Adhikari, S.R., Akkazieva, B., Harbianto, D., Garg, C.C., Hanvoravongchai, P., Herrin, A.N., Huqj, M.N., Ibragimova, S., Karan, A., Kwonm, S., Leung, G.M., Lu, J.R., Ohkusa, Y., Pande, B.R., Racelis, R., Tin, K., Tisayaticom, K., Trisnantoro, L., Wan, Q., Yangm, B.M., Zhao, Y. 2008. Who pays for health care in Asia? Journal of Health Economics 27: 460-475.
O'Donnell, O., van Doorslaer, E., Wagstaff, A. 2007. and Lindelow, M. Analyzing Health Equity Using Household Survey Data - A Guide to Techniques and Their Implementation. The World Bank: Geneva.
Statistical Center of Iran (1995-2005). Household Expenditure and Income Surveys. Tehran: Statistical Center of Iran.
Statistical Center of Iran. 2005. Records Complex-Household Expenditure and Income Survey in Urban and Rural Areas. The Management and Planning Organization of Iran: Tehran.
The Central Bank of the Islamic Republic of Iran (2009). Economic Time Series Database. http://tsd.cbi.ir/IntTSD/EnDisplay/Display.aspx
Wagstaff, A. 2002. Measuring equity in health care nancing: reections and alternatives to the world health organization's fairness of financial contribution index. Health Economics 11: 103-115.
Wagstaff, A., van Doorslaer, E. 2000. Equity in health care finance and delivery. In A. Culyer, J. P. Newhouse (eds) Handbook of Health Economics 1B: 1803-1861. Elsevier Science, Amsterdam (2000)
Wagstaff, A., van Doorslaer, E., van der Burg, H., Calonge, S., Christiansen, T., Citoni, G., Gerdtham, U.G., Gern, M., Gross, L., Hakinnen, U., Johnson, P., John, J., Klavus, J., Lachaud, C., Lauritsen, J., Leu, R., Nolan, B., Peran, E., Pereira, J., Propper, C., Puffer, F., Rochaix, L., Rodrguez, M., Schellhorn, M., Sundberg, G., Winkelhake, O. 1999. Equity in the nance of health care: some further international comparisons. Journal of Health Economics 18: 263-292.
Wagstaff, A., van Doorslaer, E. 1992. Equity in the nance of health care: some international comparisons. Journal of Health Economics 11, 361-387.
Wagstaff, A., van Doorslaer, E., Paci, P. 1989. Equity in the finance and delivery of health care: some tentative cross-country comparisons. Oxford Review of Economics and Policy 5: 89-112.
Wilkinson, R.G. 1995. Variation in health. British Medical Journal 311, 1177-78.
World Health Organization 2008. National Health Accounts Series. http://www.who.int/nha/country/irn/en/. [25 January 2008]
World Health Organization. 2000. Health Systems: Improving Performance. World Health Organization: Geneva.
Xu, K., Klavus, J., Kawabata, K., Evans, D.B., Hanvoravongchai, P., Ortiz, J. P., Zeramdini, R., Murray, C.J.L. 2003. Household health system contributions and capacity to pay: definitional, empirical, and technical challenges. in: C.J.L. Murray and D.B. Evans (eds). Health Systems Performance Assessment: Debates, Methods and Empiricism, 533-543. World Health Organization: Geneva.