IDEAS home Printed from https://ideas.repec.org/p/pra/mprapa/14672.html
   My bibliography  Save this paper

Equity of health care financing in Iran

Author

Listed:
  • Hajizadeh, Mohammad
  • Connelly, Luke B.

Abstract

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.

Suggested Citation

  • Hajizadeh, Mohammad & Connelly, Luke B., 2009. "Equity of health care financing in Iran," MPRA Paper 14672, University Library of Munich, Germany.
    • Handle: RePEc:pra:mprapa:14672
    as

    Download full text from publisher

    File URL: https://mpra.ub.uni-muenchen.de/14672/1/MPRA_paper_14672.pdf
    File Function: original version
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Wagstaff, Adam & van Doorslaer, Eddy & Paci, Pierella, 1989. "Equity in the Finance and Delivery of Health Care: Some Tentative Cross-country Comparisons," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 5(1), pages 89-112, Spring.
    2. Lairson, David R. & Hindson, Paul & Hauquitz, Alan, 1995. "Equity of health care in Australia," Social Science & Medicine, Elsevier, vol. 41(4), pages 475-482, August.
    3. Wagstaff, Adam & van Doorslaer, Eddy, 1992. "Equity in the finance of health care: Some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 361-387, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Aurelio Mejía, 2013. "Is tax funding of health care more likely to be regressive than systems based on social insurance in low- and middle-income countries?," Publicaciones 15615, Grupo de Economía de la Salud.
    2. Amir Fazaeli & Mohmmad Hadian & Aziz Rezapour & Ali Fazaeli, 2016. "Assessing the Distribution of Household Financial Contribution to Health System: A Case Study of Iran," Global Journal of Health Science, Canadian Center of Science and Education, vol. 8(10), pages 233-233, October.
    3. Mejía Mejía, Aurelio, 2013. "Is tax funding of health care more likely to be regressive than systems based on social insurance in low and middle-income countries?," Revista Lecturas de Economía, Universidad de Antioquia, CIE, issue 78, pages 229-239, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Luca Crivelli & Paola Salari, 2012. "Fiscal federalism and income redistribution through healthcare financing: An empirical analysis for the Swiss cantons," CEPRA working paper 1204, USI Università della Svizzera italiana.
    2. Mohammad Hajizadeh & Luke Brian Connelly & James Robert Gerard Butler, 2014. "Health Policy and Equity of Health Care Financing in Australia: 1973–2010," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 60(2), pages 298-322, June.
    3. Moradi, Alireza, 2011. "Equity of Health Care Financing: An Application to Iran," MPRA Paper 33489, University Library of Munich, Germany.
    4. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & Citoni, Guido & Di Biase, Rita & Gerdtham, Ulf-G. & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "The redistributive effect of health care finance in twelve OECD countries," Journal of Health Economics, Elsevier, vol. 18(3), pages 291-313, June.
    5. Hai Zhong, 2010. "The impact of missing data in the estimation of concentration index: a potential source of bias," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(3), pages 255-266, June.
    6. Ana I. Balsa & Máximo Rossi & Patricia Triunfo, 2011. "Horizontal Inequity in Access to Health Care in Four South American Cities," Revista de Economía del Rosario, Universidad del Rosario, June.
    7. Mohammad Hajizadeh & Luke B. Connelly & James R.G. Butler & Aredshir Khosravi, 2012. "Unmet need and met unneed in health care utilisation in Iran," International Journal of Social Economics, Emerald Group Publishing Limited, vol. 39(6), pages 400-422, May.
    8. Jennifer Roberts & Nigel Rice & Andrew M. Jones, 2008. "Early retirement and inequality in Britain and Germany: How important is health?," Working Papers 2008012, The University of Sheffield, Department of Economics, revised Nov 2008.
    9. Jones, Andrew M. & Rice, Nigel & Robone, Silvana & Dias, Pedro Rosa, 2011. "Inequality and polarisation in health systems' responsiveness: A cross-country analysis," Journal of Health Economics, Elsevier, vol. 30(4), pages 616-625, July.
    10. Mohammad Hajizadeh & Hong Nghiem, 2011. "Out-of-pocket expenditures for hospital care in Iran: who is at risk of incurring catastrophic payments?," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 267-285, December.
    11. Richard Layte & Brian Nolan, 2004. "Equity in the Utilisation of Health Care in Ireland," The Economic and Social Review, Economic and Social Studies, vol. 35(2), pages 111-134.
    12. Yasushi Ohkusa & Chika Honda, 2003. "Updated Horizontal Inequity in Health Care Utilization in Japan: Comparisons with OECD Countries Using an Original Survey," ISER Discussion Paper 0585, Institute of Social and Economic Research, Osaka University.
    13. Hai Zhong, 2010. "On decomposing the inequality and inequity change in health care utilization: change in means, or change in the distributions?," International Journal of Health Economics and Management, Springer, vol. 10(4), pages 369-386, December.
    14. Gregoire Mercier & Jenica Pastor & Valerie Clément & Ulysse Rodts & Christine Moffat & Isabelle Quéré, 2019. "Out-of-pocket payments, vertical equity and unmet medical needs in France: A national multicenter prospective study on lymphedema," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-13, May.
    15. Adam Wagstaff, 2007. "Health systems in East Asia: what can developing countries learn from Japan and the Asian Tigers?," Health Economics, John Wiley & Sons, Ltd., vol. 16(5), pages 441-456, May.
    16. Magnus Lindelow, 2006. "Sometimes more equal than others: how health inequalities depend on the choice of welfare indicator," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 263-279, March.
    17. Ms. Nora K Markova, 2006. "How Does the Introduction of Health Insurance Change the Equity of Health Care Provision in Bulgaria?," IMF Working Papers 2006/285, International Monetary Fund.
    18. Magnus Lindelow, 2002. "Sometimes More Equal than Others How the choice of welfare indicator can affect the measurement of health inequalities and the incidence of public spending," Economics Series Working Papers WPS/2002-15, University of Oxford, Department of Economics.
    19. Hajizadeh, Mohammad & Keays, Daniel, 2023. "Ten years after the 2015 Canada Health Transfer reform: A persistent equity concern of insufficient risk-equalization," Health Policy, Elsevier, vol. 129(C).
    20. Magnus Lindelow, 2004. "Sometimes More Equal than Others How the choice of welfare indicator can affect the measurement of health inequalities and the incidence of public spending," Development and Comp Systems 0409018, University Library of Munich, Germany.

    More about this item

    Keywords

    Equity; Health care nancing; Kakwani progressivity index; Iran;
    All these keywords.

    JEL classification:

    • D31 - Microeconomics - - Distribution - - - Personal Income and Wealth Distribution
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • P43 - Political Economy and Comparative Economic Systems - - Other Economic Systems - - - Finance; Public Finance
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:pra:mprapa:14672. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Joachim Winter (email available below). General contact details of provider: https://edirc.repec.org/data/vfmunde.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.