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Decomposition of gendered socioeconomic‐related inequality in outpatient health care utilization: A cross‐sectional study from Iran

Author

Listed:
  • Sajad Vahedi
  • Vajiheh Ramezani‐Doroh
  • Mohammad Shamsadiny
  • Aziz Rezapour

Abstract

Introduction Unequal access to required health care services could deteriorate inequality in health outcomes and increase mortality and morbidity, especially among disadvantaged groups. One of the most debated factors in shaping health care inequalities is gender. This study aimed to measure and explains gendered socioeconomic‐related inequality in outpatient health care utilization in Iran. Methods This is a cross‐sectional research conducted at a national level in Iran. The required data was obtained from an Iranian health care utilization household survey conducted in 2015. Erreygers Concentration Index (ECI) was used to measure the socioeconomic inequality in outpatient health care utilization. A regression‐based decomposition analysis was also used to explain socioeconomic‐related inequalities. Results There was a significant pro‐rich inequality in outpatient health care utilization between males (ECI = 0.115, SE = 0.014) and females (ECI = 0.083 SE = 0.011) indicating that utilization of these services was concentrated on the better‐offs. The decomposition analysis revealed that economic status (males = 50.58%, females = 37.42%) was the main contributor to the observed inequality. Location of residence, health insurance and education were other main driver of these inequalities. Conclusions Different factors have different contribution to socioeconomic‐related inequality in utilization of outpatient health care services and these could be diversified considering gender. Hence, it seems that policy makers could be able to address these inequalities effectively through gender‐oriented policies.

Suggested Citation

  • Sajad Vahedi & Vajiheh Ramezani‐Doroh & Mohammad Shamsadiny & Aziz Rezapour, 2021. "Decomposition of gendered socioeconomic‐related inequality in outpatient health care utilization: A cross‐sectional study from Iran," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(3), pages 656-667, May.
    • Handle: RePEc:bla:ijhplm:v:36:y:2021:i:3:p:656-667
    DOI: 10.1002/hpm.3109
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    References listed on IDEAS

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    1. Tayebeh Moradi & Seyran Naghdi & Heather Brown & Hesam Ghiasvand & Mohammadreza Mobinizadeh, 2018. "Decomposing inequality in financial protection situation in Iran after implementing the health reform plan: What does the evidence show based on national survey of households' budget?," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(3), pages 652-661, July.
    2. Nina L. Hall & Sophie Matthews & Arabella Hickson & Peter S. Hill, 2019. "Health and the Sustainable Development Goals: Challenges for four Pacific countries," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 844-859, January.
    3. 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.
    4. Adam Wagstaff & Eddy van Doorslaer, 2000. "Measuring and Testing for Inequity in the Delivery of Health Care," Journal of Human Resources, University of Wisconsin Press, vol. 35(4), pages 716-733.
    5. Macintyre, Sally & Hunt, Kate & Sweeting, Helen, 1996. "Gender differences in health: Are things really as simple as they seem?," Social Science & Medicine, Elsevier, vol. 42(4), pages 617-624, February.
    6. Dilek Başar & Selcen Öztürk, 2020. "Assessing Horizontal Equity in the Utilization of Mental Healthcare Services in Turkey: A Gender Perspective," Applied Health Economics and Health Policy, Springer, vol. 18(2), pages 299-309, April.
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