| Introduction: One of the main objectives of health systems is providing financial protection
against out-of-pocket (OOP) health expenditures. According to the 2011 report by the World
Health Organization in the Eastern Mediterranean Regional Office (EMRO), a huge portion
of health service in Iran is paid OOP, which is around 58% of the total health system
expenditure. Furthermore, all over the world, around 25 million households (100 million
people) are trapped in poverty as a result of paying health service costs. Therefore, this
research was aimed at investigating the OOP and exposure of households with catastrophic
health expenditures (CHE) following the implementation of a health transformation plan in
Tabriz, Iran.
Methods: A descriptive-analytic study was conducted on a cross-sectional basis. The
sample included 400 households, who were interviewed using the World Health Survey
questionnaire, and then OOP payment and exposure of households to CHE were estimated,
and the effective factors on OOP payment and the determinants of CHE were analyzed using
a regression model.
Results: After implementing the health transformation plan, the average share of households’
OOP payments, toward their ability to pay was 13.2%. In addition, 11.25% of the
households were exposed to CHE in Tabriz. The key determinants of OOP were income,
dental services, pharmaceuticals, radiology, and physiotherapy. The factors affecting CHE
were income, insurance status, marital status, dental services, pharmacy, physiotherapy, and
radiological services.
Conclusion: Based on the results of the current study and compared to similar research
conducted prior to this plan, it is obvious that the transformation plan was able to achieve
its goal in “reducing OOP payments”. However, health services such as dental, pharmacy,
physiotherapy, and radiology would increase the likelihood of facing OOP payments.
These variables should be considered by health policy-makers in order to review and
revise the |