scholarly journals Catastrophic Health Expenditures for Children with Disabilities in Iran: A National Survey

2020 ◽  
Author(s):  
Ghobad Moradi ◽  
Amjad Mohamadi Bolbanabad ◽  
Farman Zahir Abdullah ◽  
Hossein Safari ◽  
Satar Rezaei ◽  
...  
Keyword(s):  
Health Insurance ◽  
Financial Burden ◽  
Health Expenditures ◽  
World Health ◽  
Health Costs ◽  
Financial Protection ◽  
Disabled Children ◽  
World Health Survey ◽  
Cross Sectional ◽  
Catastrophic Health Expenditures

Abstract Background: Higher health costs and financial burden are imposed on people with disabilities due to their health status associated with their disability. Measuring the incidence of catastrophic health expenditures (CHE) can provide good evidence for health policymakers to assess the current state of financial protection of the health system. The aim of this study was to investigate the percentage of households with disabled children aged 0 to 8 years who had faced CHE due to the health costs of these children in Iran.Methods: This cross-sectional study was carried out on 2000 households with disabled children aged 0 to 8 years in five provinces of Iran in 2020. Data were collected using the World Health Survey questionnaire and face-to-face interview. Households whose health expenditures for disabled members in the family were more than 40% of the household payment capacity were included in the group of households with CHE. Determinants of CHE were identified using logistic regression.Findings: 32.7% of households with disabled children had faced CHE. Head of household being female (Adjusted OR=18.89, 95%CI: 10.88- 29.42), poor economic status of the household (Q1: Adjusted OR = 20.26, 95% CI, 11.42-35.94; Q2: Adjusted OR= 8.27, 95%CI, 4.45-15.36; Q3: Adjusted OR= 13.88, 95%CI, 7.89-24.41), lack of supplementary insurance by a child with disabilities (Adjusted OR= 6.13, 95%CI, 3.39-11.26), having a child with mental disability (Adjusted OR= 2.71, 95%CI, 1.60-4.69), and type of basic health insurance [having Iranian Health Insurance: Adjusted OR= 2.20, 95%CI, 1.38-3.49; having Social security insurance: Adjusted OR= 1.66, 95%CI, 1.06-2.61] significantly increased the chances of facing CHE.Conclusion: A significant percentage of households with disabled children had faced CHE because of their disabled child's health costs. The key determinants of CHE should be considered by health policy-makers in order to more financial protection of these households.

scholarly journals Catastrophic Health Expenditures for Children with Disabilities in Iran: A National Survey

2020 ◽  
Author(s):  
Ghobad Moradi ◽  
Amjad Mohamadi Bolbanabad ◽  
Farman Zahir Abdullah ◽  
Hossein Safari ◽  
Satar Rezaei ◽  
...  
Keyword(s):  
Health Insurance ◽  
Financial Burden ◽  
Health Expenditures ◽  
World Health ◽  
Health Costs ◽  
Financial Protection ◽  
Disabled Children ◽  
World Health Survey ◽  
Cross Sectional ◽  
Catastrophic Health Expenditures

Abstract Background: Higher health costs and financial burden are imposed on people with disabilities due to their health status associated with their disability. Measuring the incidence of catastrophic health expenditures (CHE) can provide good evidence for health policymakers to assess the current state of financial protection of the health system. The aim of this study was to investigate the percentage of households with disabled children aged 0 to 8 years who had faced CHE due to the health costs of these children in Iran.Methods: This cross-sectional study was carried out on 2000 households with disabled children aged 0 to 8 years in five provinces of Iran in 2020. Data were collected using the World Health Survey questionnaire and face-to-face interview. Households whose health expenditures for disabled members in the family were more than 40% of the household payment capacity were included in the group of households with CHE. Determinants of CHE were identified using logistic regression.Findings: 32.7% of households with disabled children had faced CHE. Head of household being female (Adjusted OR=18.89, 95%CI: 10.88- 29.42), poor economic status of the household (Q1: Adjusted OR = 20.26, 95% CI, 11.42-35.94; Q2: Adjusted OR= 8.27, 95%CI, 4.45-15.36; Q3: Adjusted OR= 13.88, 95%CI, 7.89-24.41), lack of supplementary insurance by a child with disabilities (Adjusted OR= 6.13, 95%CI, 3.39-11.26), having a child with mental disability (Adjusted OR= 2.71, 95%CI, 1.60-4.69), and type of basic health insurance [having Iranian Health Insurance: Adjusted OR= 2.20, 95%CI, 1.38-3.49; having Social security insurance: Adjusted OR= 1.66, 95%CI, 1.06-2.61] significantly increased the chances of facing CHE.Conclusion: A significant percentage of households with disabled children had faced CHE because of their disabled child's health costs. The key determinants of CHE should be considered by health policy-makers in order to more financial protection of these households.

scholarly journals Catastrophic Health Expenditures for Children with Disabilities in Iran: A National Survey

2020 ◽  
Author(s):  
Ghobad Moradi ◽  
Amjad Mohamadi Bolbanabad ◽  
Farman Zahir Abdullah ◽  
Hossein Safari ◽  
Satar Rezaei ◽  
...  
Keyword(s):  
Financial Burden ◽  
Health Expenditures ◽  
World Health ◽  
Health Costs ◽  
Financial Protection ◽  
Disabled Children ◽  
World Health Survey ◽  
Cross Sectional ◽  
Out Of Pocket Payments ◽  
Catastrophic Health Expenditures

Abstract Background: Higher health costs and financial burden are imposed on people with disabilities due to their health status associated with their disability. Measuring the incidence of catastrophic health expenditures (CHE) can provide good evidence for health policymakers to assess the current state of financial protection of the health system. The aim of this study was to investigate the percentage of households with disabled children aged 0 to 8 years who had faced CHE due to the health costs of these children in Iran.Methods: This cross-sectional study was carried out on 2000 households with disabled children aged 0 to 8 years in five provinces of Iran in 2020. Data were collected using the World Health Survey questionnaire and face-to-face interview. Households whose health expenditures for disabled members in the family were more than 40% of the household payment capacity were included in the group of households with CHE. Determinants of CHE were identified using regression analysis.Findings: 32.7% of households with disabled children had faced CHE. Head of household being female, poor economic status of the household, lack of supplementary insurance by a child with disabilities, having a child with mental disability and type of basic health insurance significantly increased the chances of facing CHE.Conclusion: A significant percentage of households with disabled children had faced CHE because of their disabled child's health costs. More financial protection of these households against health costs should be on the agenda of health policy makers. Implementation of payment exemption programs, direct and indirect financial support programs and having prepaid mechanisms are suggested to reduce out-of-pocket payments for health services.

scholarly journals Catastrophic Health Expenditure before and after of the Implementation of Health Sector Evolution Plan in Iran

2021 ◽  
Vol 58 ◽  
pp. 004695802110502
Author(s):  
Razieh Ahmadi ◽  
Milad Shafiei ◽  
Hosein Ameri ◽  
Roohollah Askari ◽  
Hossein Fallahzadeh
Keyword(s):  
Health Insurance ◽  
Economic Status ◽  
Health Sector ◽  
Health Expenditures ◽  
Catastrophic Health Expenditure ◽  
Financial Protection ◽  
Outpatient Services ◽  
Incremental Change ◽  
Inpatient Services ◽  
Catastrophic Health Expenditures

Introduction: One of the fundamental goals of health transportation plan (HTP) in Iran is to improve household’s financial protection against catastrophic health expenditures (CHE). The aim of this study was to calculate the percentage of catastrophic health expenditures after implementing the plan and compare it with CHE before the plan for the same households. Methods: Data were collected through face-to-face interviews for 400 households. The CHE was calculated using the WHO approach, and relationships between CHE and the variables (having member ≥65 years old, having member ≤5 years old, having disabled member, economic status, health insurance status, dentistry services usage, and inpatient and outpatient services usage) were examined by the Fisher’s exact test. Moreover, the impacts of the variables on CHE were assessed by logistic regression model. Stata version 15 was used for data analyses. Results: The exposure of the households to CHE increased from 8.3% in 2011 to 14.2% in 2020, and percentage of the impoverished households due to health expenditures in 2020 was more than that of the 2011 (4.3% vs 7.5%). The economic status, having members ≥65 years, and using dental and inpatient services were the key factors determining the CHE. The most important determinant affecting the exposure to CHE was dental services utilization in 2011 (92.64) and 2020 (122.68). Conclusion: The results showed a negative incremental change for the households facing CHE in this period. The dental and inpatient services need to be more widely covered by basic health insurance and households having members ≥65 years along with the poor households should be exempted from paying some of the healthcare expenditures for improving their financial protection against CHE.

scholarly journals Fear of catastrophic health expenditures and unrealistic expectations from supplementary health insurance: ethnic differences

2018 ◽  
Vol 11 (4) ◽  
pp. 283-289
Author(s):  
Neta HaGani ◽  
Samah Hayek ◽  
Jalal Tarabeia ◽  
Mohammad Yehia ◽  
Manfred S Green
Keyword(s):  
Health Insurance ◽  
Health Expenditures ◽  
Health Coverage ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Accessible Information ◽  
Catastrophic Health Expenditures ◽  
Supplementary Health Insurance ◽  
Universal Health ◽  
Unrealistic Expectations

Abstract Background In Israel, the whole population is covered by comprehensive universal health insurance. Despite that, most of the population purchases supplementary health insurance (SHI). It has been shown that individuals purchase more health insurance and preventive medicine when they are uncertain of their state of health, while a majority may not fully understand basic concepts in their health insurance coverage. The purpose of this study was to examine the role of fear of catastrophic health expenditures and unrealistic expectations in purchasing SHI, which does not cover expenses for life-threatening illnesses. Methods A cross-sectional survey was conducted among random samples of 814 Jews and 800 Arabs in Israel. A structured questionnaire was administered by telephone using random digit dialling. Log-linear regression was used to identify factors associated with reasons for purchasing SHI and expectations from SHI. Results The most common reason for purchasing SHI was fear of catastrophic health-related expenditures (41%). The most important service expected from SHI was ‘cancer medications’ (mean 4.68 [standard deviation 0.87]). Differences in the reasons for purchasing SHI and in expectations from SHI were found according to population group, age, gender and education. Conclusions Consumers’ misconceptions and fear of catastrophic health expenditures are major factors leading to the purchase of SHI, despite universal health coverage. Improved and accessible information should help consumers make informed decisions as to whether or not to purchase SHI.

scholarly journals Household catastrophic health expenditure and its effective factors: a case of Iran

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ramin Ravangard ◽  
Faride Sadat Jalali ◽  
Mohsen Bayati ◽  
Andrew J. Palmer ◽  
Abdosaleh Jafari ◽  
...  
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Expenditures ◽  
Health Care Expenditures ◽  
Health Insurance Coverage ◽  
World Health ◽  
P Value ◽  
Cross Sectional ◽  
Supplementary Health Insurance ◽  
Multiple Logistic Regression Modeling

Abstract Background The World Health Organization (WHO) has placed special emphasis on protecting households from health care expenditures. Many households face catastrophic health expenditures (CHEs) from a combination of economic poverty and financing the treatment of medical conditions. The present study aimed to measure the percentage of households facing catastrophic CHEs and the factors associated with the occurrence of CHEs in Shiraz, Iran in 2018. Methods The present cross-sectional study was performed on 740 randomly selected households from different districts of Shiraz, Iran in 2018 using a multi-stage sampling method. Data were collected using the Persian version of the “WHO Global Health Survey” questionnaire. CHEs were defined as health expenditures exceeding 40% of households’ capacity to pay. Households living below the poverty line before paying for health services were excluded from the study. The associations between the households’ characteristics and facing CHEs were determined using the Chi-Square test as well as multiple logistic regression modeling in SPSS 23.0 at the significance level of 5%. Results The results showed that 16.48% of studied households had faced CHEs. The higher odds of facing CHEs were observed in the households living in rented houses (OR = 3.14, P-value < 0.001), households with disabled members (OR = 27.98, P-value < 0.001), households with children under 5 years old (OR = 2.718, P-value = 0.02), and those without supplementary health insurance coverage (OR = 1.87, P-value = 0.01). Conclusion CHEs may be reduced by increasing the use of supplementary health insurance coverage by individuals and households, increasing the support of the Social Security and the State Welfare Organizations for households with disabled members, developing programs such as the Integrated Child Care Programs, and setting home rental policies and housing policies for tenants.

scholarly journals Household Catastrophic Health Expenditure and Its Effective Factors: A Case of Iran

2020 ◽  
Author(s):  
Abdosaleh Jafari ◽  
Farideh Sadat Jalali ◽  
Mohsen Bayati ◽  
Andrew J. Palmer ◽  
Peivand Bastani ◽  
...  
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Health Expenditures ◽  
Health Care Expenditures ◽  
Health Insurance Coverage ◽  
World Health ◽  
P Value ◽  
Cross Sectional ◽  
Significance Level ◽  
Supplementary Health Insurance

Abstract Background:The World Health Organization (WHO) has placed special emphasis on protecting households from health care expenditures. Many households face catastrophic health expenditures (CHEs) from a combination of economic poverty and financing the treatment of medical conditions. The present study aimed to measure the percentage of households facing catastrophic CHEs and the factors associated with the occurrence of CHEs in Shiraz, Iran in 2018.Methods:The present cross-sectional study was performed on 740 randomly selected households from different districts of Shiraz, Iran in 2018 using a multi-stage sampling method. Data were collected using the Persian version of the "WHO Global Health Survey” questionnaire. CHEs were defined as health expenditures exceeding 40% of households’ capacity to pay. The associations between the households’ characteristics and facing CHEs were determined using the Chi-Square test as well as multiple logistic regression modelling in SPSS 23.0 at the significance level of 5%. Results:The results showed that 16.48% of studied households had faced CHEs. The higher odds of facing CHEs were observed in the households living in rented houses (OR=3.14, P-value<0.001), households with disabled members (OR=27.98, P-value<0.001), households with children under 5 years old (OR=2.718, P-value=0.02), and those without supplementary health insurance coverage (OR=1.87, P-value=0.01).Conclusion:CHEs may be reduced by increasing the use of supplementary health insurance coverage by individuals and households, increasing the support of the Social Security and the State Welfare Organizations for households with disabled members, developing programs such as the Integrated Child Care Programs, and setting home rental policies and housing policies for tenants.

Catastrophic health expenditure and its determinants in households with gastrointestinal cancer patients: evidence from new health system reform in Iran

2019 ◽  
Vol 12 (4) ◽  
pp. 249-257
Author(s):  
Bakhtiar Piroozi ◽  
Bushra Zarei ◽  
Bayazid Ghaderi ◽  
Hossein Safari ◽  
Ghobad Moradi ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health System ◽  
Cancer Patients ◽  
Gastrointestinal Cancer ◽  
Healthcare Services ◽  
World Health ◽  
World Health Survey ◽  
Cross Sectional ◽  
Content Type ◽  
Effective Factors

Purpose The right to health for all people means that everyone should have access to the needed healthcare services without suffering from severe financial hardship. The purpose of this paper is to investigate the prevalence as well as the effective factors on facing catastrophic health expenditures (CHE) among gastrointestinal cancer patients and families in Kurdistan province in west of Iran after the implementation of Health Transformation Plan (HTP). Design/methodology/approach A cross-sectional study was carried out on 189 households with gastrointestinal cancer patients in Kurdistan province in 2018. Data were collected using World Health Survey questionnaire. A method developed by World Health Organization with the threshold of 40 percent household’s capacity to pay was used in order to measure the proportion of households facing CHE. Also, logistic regression was applied for identifying the effective factors on household’s exposure to CHE. Data were analyzed using STATA version 13. Findings Almost 73 percent (72.7 percent) of the households (n=117) faced the CHE. Not having supplementary health insurance (adjusted odds ratio (AOR): 3.8; 95% confidence interval: 1.3–10.8 (and having low socio-economic status (AOR: 7.1; 95% CI: 1.8–28.1) were the significant factors affecting the households’ exposure to CHE. In total, 57 and 1 percent of the studied households reported that having a gastrointestinal cancer patient at home had a significant effect on refraining from using health services by other family members. Originality/value The proportion of the studied households facing CHE was very high. This may indicate the weakness of health system as well as health insurance or the weakness of HTP in financial protection of fragile population.

scholarly journals Association of Edentulism with Various Chronic Diseases in Mexican Elders 60+ Years: Results of a Population-Based Survey

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 404
Author(s):  
Alejandro José Casanova-Rosado ◽  
Juan Fernando Casanova-Rosado ◽  
Mirna Minaya-Sánchez ◽  
José Luís Robles-Minaya ◽  
Juan Alejandro Casanova-Sarmiento ◽  
...  
Keyword(s):  
Angina Pectoris ◽  
Mental Disorders ◽  
Chronic Diseases ◽  
Population Based ◽  
Self Report ◽  
World Health ◽  
Complex Nature ◽  
Cluster Sampling ◽  
World Health Survey ◽  
Cross Sectional

Objective: To determine the association of edentulism with different chronic diseases and mental disorders in Mexicans aged 60 years and over. Material and Methods: A cross-sectional study was carried out using data from the World Health Survey for Mexico, in a probabilistic, multi-stage cluster sampling framework. Data for self-report of chronic diseases (diabetes, arthritis, angina pectoris and asthma), mental disorders (depression and schizophrenia) and edentulism were analyzed. Edentulism data were available for 20 of the 32 States of Mexico. Statistical analysis was performed in Stata 14.0 using the svy module for complex sampling (Complex nature under which individuals are sampled). Results: In total 4213 subjects were included, representing a population of 7,576,057 individuals. Mean age was 70.13 ± 7.82 years (range 60 to 98); 56.2% were women. Chronic diseases’ prevalence and mental disorders prevalence were as follows: diabetes 15.0% (N = 1,132,693); arthritis 13.2% (N = 1,001,667); depression 5.5% (N = 414,912); angina pectoris 4.5% (344,315); asthma 3.6% (N = 269,287); and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which pertained to 1,993,463 people aged 60 years and over. Angina in women aged 60 to 69 years (p < 0.05) and depression in men aged 70 years and over (p < 0.0001) were associated with higher prevalence of edentulism. Conclusions: There was generally sparse association between edentulism on chronic diseases and mental disorders included in the study, except for women aged 60 to 69 years for angina, and in men aged 70 and over, for depression. Although our findings are misaligned with previous reports, longitudinal studies are required to test causal and temporal relationships between edentulism with chronic diseases and mental disorders.

The Risk of Catastrophic Health Expenditures Due to Direct Non-Medical Costs in Patients: A Study of the Outpatients in Qazvin, Iran

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Saeed Asefzadeh ◽  
Bahman Ahadi Nezhad ◽  
Saeed Norouzi
Keyword(s):  
Health Expenditures ◽  
Medical Costs ◽  
Healthcare Services ◽  
Disease Diagnosis ◽  
Cross Sectional Survey ◽  
Diagnostic Laboratory ◽  
Cross Sectional ◽  
Out Of Pocket Payments ◽  
Catastrophic Health Expenditures ◽  
Catastrophic Expenditures

Background: Out-of-pocket payment encompasses the costs that patients pay for healthcare services, which is an inefficient approach to healthcare financing as it may lead to poverty. Objectives: The present study aimed to determine the risk of catastrophic health expenditures due to non-medical costs in the outpatients in Qazvin, Iran. Methods: This cross-sectional survey was conducted on 341 outpatients referring to the internists of Velayat Hospital and Bu-Ali Sina Hospital in Qazvin. The required data were collected using a researcher-made questionnaire and the prescriptions of the patients. Out-of-pocket payments were defined as the direct medical and non-medical costs within one month. Results: The mean out-of-pocket payments of the patients in one month was 49.97 dollars, 75.8% of which covered direct medical cost (disease diagnosis and treatment), and 24.2% covered direct non-medical costs to receive health services. The highest out-of-pocket payments were for diagnostic/laboratory tests (50.3%), medications (21.5%), and transportation (18.2%). In addition, the exposure rate to catastrophic expenditures was estimated at 31%, and the patients with lower income had less exposure compared to those without incomes. Conclusions: According to the results, direct non-medical costs were associated with the increased out-of-pocket payments of the patients, which in turn led to the higher rates of catastrophic expenditures.

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