| Background and Objectives: Out-of-pocket (OOP) expenditure is one of the main indicators in health financing,
indicating risk pooling and risk spreading. This study aimed to calculate the total health expenditure (THE), the
THE per capita and share of OOP in each province from 2008 to 2014.
Methods: The present cross-sectional study was done by collecting provincial health expenditure data from
public and private organizations during 2008-2014. The data were approved by board of trustees or board of
directors in each organization. The relevant data on household health expenditures were collected from the
Statistical Centre of Iran, as well.
Results: Even though the absolute monetary value (IRR) of OOP in the study years showed an increase, it
decreased from 51.9% in 2008 to 40.6% in 2014 in terms of share. The absolute monetary value (IRR) of THE
and THE per capita increased about 3.5 times in all provinces. So, during the study years, Tehran and Sistan and
Baluchistan Provinces had the highest and lowest absolute monetary values (IRR) in THE per capita and this
difference increased from 2.12 million Rials in 2008 to 10.56 million Rials in 2014.
Conclusion: Although the share of OOP decreased in all provinces in the country during the study years, it is still
far from the objective of the national development plans (30% OOP). In order to improve the study indices and
reduce the provincial inequity, it is suggested to put more emphasis on prepaid-based mechanisms, insurance
system improvement, and equitable distribution of financial resources should be compatible with the deprivation
of the area and its infrastructures. |