Volume 18, Issue 8 (November 2020)                   Nursing and Midwifery Journal 2020, 18(8): 625-635 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Nabilou B, Golparipour S, Alinia C, yusefzadeh H. THE EFFECT OF HEALTH REFORM IMPLEMENTATION ON THE OUT-OF-POCKET PAYMENTS OF PATIENTS: A CASE STUDY OF IRAN. Nursing and Midwifery Journal 2020; 18 (8) :625-635
URL: http://unmf.umsu.ac.ir/article-1-4119-en.html
1- Department of Health Economics and Management, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
2- Department of Health Economics and Management, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran (Corresponding Author , hyusefzade2010@yahoo.com
Abstract:   (2362 Views)
Background & Aims: One of the important aspects of the health system reform plan is the protection of households and patients against medical expenses. They suffer from the financial burden of paying for medical expenses, as well as their illness. This study aimed to estimate the out-of-pocket payment of patients for medical expenses in Urmia in 2017. Materials & Methods: In this descriptive-analytical study, to estimate out-of-pocket, data were collected in three stages from 400 households who were selected randomly from the four main health care centers in Urmia. Data were gathered through questionnaires and interviews with the head of the household, hospital records, insurance organizations, and medical tariffs, and were analyzed using SPSS software version 16. Results: According to the results, the average amount of out-of-pocket direct payment was calculated to be 53.07%. Basic insurance, supplementary insurance, and self-treatment were allocated 32.79%, 11.17% and 2.94% of total treatment costs, respectively. Conclusion: The results of the study and comparisons with pre-implementation health reform plan studies showed that this plan is very successful in the inpatient area and the OOP rate is significantly lower than the designated target but in the outpatient area, the plan is not successful, mainly due to the high costs in the dental services sector and the lack of support by insurance organizations.  
Full-Text [PDF 2643 kb]   (630 Downloads)    
Type of Study: Research | Subject: بهداشت

1. Espina PZ, Arechavala NS. An assessment of social welfare in Spain: Territorial analysis using a synthetic welfare indicator. Soc Indic Res 2013;111(1):1-23. [DOI:10.1007/s11205-012-0005-0]
2. Mikkelsen-Lopez I, Wyss K, de Savigny D. An approach to addressing governance from a health system framework perspective. BMC Int Health Hum Rights 2011;11(1):13. [DOI:10.1186/1472-698X-11-13] [PMID] [PMCID]
3. Savedoff WD, Ferranti F, Smith A. Transitions in health financing and policies for universal health coverage. Washington, DC: Centre for Global Development; 2012. [Google Scholar]
4. Organization WH. The world health report: health systems financing: the path to universal coverage: executive summary. World Health Organization; 2010. [Google Scholar]
5. Hanjani H, Fazaeli A. Estim ation of fair financial contribution in health system of iran. Social Welfare Quarterly2006; 5 (19) :279-300. [Google Scholar]
6. Berman PA. National health accounts in developing countries: appropriate methods and recent applications. Health economics 1997;6(1):11-30. https://doi.org/10.1002/(SICI)1099-1050(199701)6:1<11::AID-HEC238>3.0.CO;2-7 [DOI:10.1002/(SICI)1099-1050(199701)6:13.0.CO;2-7]
7. Organization WH. The world health report 2000: health systems: improving performance. World Health Organization; 2000. [Google Scholar]
8. Koch KJ, Pedraza CC, Schmid A. Out-of-pocket expenditure and financial protection in the Chilean health care system-a systematic review. Health Policy 2017;121(5):481-94. [DOI:10.1016/j.healthpol.2017.02.013] [PMID]
9. Karami M, Najafi F, Karami Matin B. Catastrophic health expenditures in Kermanshah, west of Iran: magnitude and distribution. J Res Health Sci 2009;9(2):36-40. [PMID]
10. Abdi Z, Hsu J, Ahmadnezhad E, Majdzadeh R, Harirchi I. An analysis of financial protection before and after the Iranian Health Transformation Plan. East Mediterr Health J 2020 ;26(9):1025-33. [DOI:10.26719/emhj.19.026] [PMID]
11. Van Doorslaer E, O'Donnell O, Rannan‐Eliya RP, Somanathan A, Adhikari SR, Garg CC, et al. Catastrophic payments for health care in Asia. Health economics 2007;16(11):1159-84. [DOI:10.1002/hec.1209] [PMID]
12. Kruk ME, Goldmann E, Galea S. Borrowing and selling to pay for health care in low-and middle-income countries. Health Aff 2009;28(4):1056-66. [DOI:10.1377/hlthaff.28.4.1056] [PMID]
13. Wagstaff A, Dmytraczenko T, Almeida G, Buisman L, Hoang-Vu Eozenou P, et al. Assessing Latin America's progress toward achieving universal health coverage. Health Aff 2015;34(10):1704-12. [DOI:10.1377/hlthaff.2014.1453] [PMID]
14. Zare H, Trujillo AJ, Driessen J, Ghasemi M, Gallego G. Health inequalities and development plans in Iran; an analysis of the past three decades (1984-2010). International journal for equity in health 2014;13(1):42. [DOI:10.1186/1475-9276-13-42] [PMID] [PMCID]
15. Mirabedini SA, Hashemi SMEF, Asiabar AS, Rezapour A, Azami-Aghdash S, Amnab HH. Out-of-pocket and informal payments in Iran's health care system: A systematic review and meta-analysis. Med J I.R. Iran 2017;31:70. [DOI:10.14196/mjiri.31.70] [PMID] [PMCID]
16. Mehrolhassani M, Najafi B, Yazdi Feyzabadi V, Haghdoost A, Abolhallaje M, Ansari M, et al. Total health expenditures and proportion of out-of-pocket payments in Iranian provinces; 2008-2014. Iran J Epidemiol 2017;12(5Special Issue):1-12. [Google Scholar]
17. Rezaei S, Arab M. Effects of the new health reform plan on the performance indicators of Hamedan university hospitals. J Sch Public Health Inst Public Health Res 2016;14(2):51-60. [Google Scholar]
18. Sajadi HS, Zaboli R. An assessment of the positive effects of health reform plan implementation from the perspective of hospital directors. Health information management 2016; 13 (1): 55-60. [Google Scholar]
19. Keshavarz A, Kalhor R, Javadi A, Asefzadeh S. Estimating Out of Pocket payments (oop) for medical cares in Qazvin province in 2009. Hospital 2012;4(39):71-7. [Google Scholar]
20. Piroozi B, Rashidian A, Moradi G, Takian A, Ghasri H, Ghadimi T. Out-of-pocket and informal payment before and after the health transformation plan in Iran: evidence from hospitals located in Kurdistan, Iran. International journal of health policy and management 2017;6(10):573. [DOI:10.15171/ijhpm.2017.16] [PMID] [PMCID]
21. Braveman P, Gruskin S. Defining equity in health. J Epidemiol Community Health 2003;57(4):254-8. [DOI:10.1136/jech.57.4.254] [PMID] [PMCID]
22. Maher A. The story of catastrophic medical payment, sepid weekly, no. 244. March; 2001.
23. Moradi-Lakeh M, Vosoogh-Moghaddam A. Health sector evolution plan in Iran; equity and sustainability concerns. International journal of health policy and management 2015;4(10):637. [DOI:10.15171/ijhpm.2015.160] [PMID] [PMCID]
24. Heydarian M, Shaghayegh V. The effects of healthcare development of the health system to pay out of pocket patients in public hospitals of Isfahan. Journal of the Medical Council of the Islamic Republic of Iran 2015;33(3):187-94. [URL]
25. Nahvi M, Zarei E, Marzban S, Jahanmehr N. Utilization of dental services and its out-of-pocket payments: a study in dental clinics of Ramsar. Journal of Mashhad Dental School 2017;41(2):171-82. [URL]
26. Gharibi F. The percentage of out_of_pocket payment for health services by people in Kurdistan province in 2009. Sci J Kurdistan Univ Med Sci 2009;18:8-20. [URL]
27. WHO. Health system financing profile by country. available from: http://appswhoint/nha/database/country_profile/index/enaccessed/2015. [URL]
28. WHO. World Health Orgznization. Health financing. available from: http://wwwwhoint/gho/health_financing/en/ 2015. [URL]
29. Behzadifar M, Beyranvand T, Jafari M, Behzadifar M, Mirghaed MT, Martini M, et al. A Description of the Temporal Pattern of Out-of-Pocket Expenditure Related to Iranian Healthcare Services during 1995-2014. Iran J Public Health 2018;47(10):1552. [PMCID]
30. Chang AY, Cowling K, Micah AE, Chapin A, Chen CS, Ikilezi G, et al. Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050. Lancet 2019;393(10187):2233-60. [DOI:10.1016/S0140-6736(19)30841-4] [PMID]

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Nursing And Midwifery Journal

Designed & Developed by : Yektaweb