Inequality in the Distribution of Health Expenditures in 22 Districts of Tehran

Background and purpose: In 2000 World Health Organization (WHO) has announced the fairness of financial contribution to health care costs, as one of the three goals of health systems. However, conducted studies in Iran reflect the dire situation in the context of health equity in terms of financing health care costs. The aim of the present study is to determine the disparities in health expenditures by means of different approaches. Materials and Methods: The present study is a descriptive - analytic cross sectional population based study. The Sample consisted of 792 households residing in Tehran. Data was collected by WHO questionnaire. Indices of FFC, CI in health expenditure, Lorenz curve and catastrophic health care expenditure were used for measuring inequality in the distribution of health expenditures. Excel software was used to perform mathematical calculations. Results: FFC index was 0.57 by optimized method and was equal to 0.62 by ordinary formulas. Concentration index in outpatient services was -0.105, CI in inpatient services was 0.015 and for total health expenditures was equal to -0.044. Also, 7.2 present of households were faced with catastrophic health expenditures. Moreover results showed that insurance can be a reason of catastrophic expenditures by itself. Conclusion: Results indicated that there is a deep gap between the status of equity which is outlined in the 4th and 5th national plans of development and our current situation. So reforming in financial, insurance and structural policies is crucially needed.