Background: Human capital is one of the key factors in sustainable development, and health is an important part of human capital. According to this, a major goal of the Fifth and Sixth Development Plans in Iran was the establishment of regional equilibrium and justice as well as reduction of inequality in health indicators. Objectives: This research aimed at ranking and comparing Iranian provinces in terms of the level of development of health indicators and the utilization of resources in the final year of the Fifth Plan (2015). Methods: Following the objectives of the research and based on 17 indicators, the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method was applied to calculate and compare provincial development level in health indicators during year 2015. Besides, the Moran test was used to examine the impact of development of health indicators in a province on neighboring provinces' indicators. Results: In the final year of the Fifth Plan (2015), among thirty-one provinces studied, Semnan and Khuzestan had the highest and the lowest levels of healthcare development in the country, respectively. In this area, the five provinces of Semnan, Markazi, Yazd, and Southern Khorasan were respectively the most benefited while Qom, Kerman, Sistan and Baluchestan, Alborz, and Khuzestan were the most deprived provinces of the country. Also, an inverse relationship was found between greater concentration of resources in a region and less resources and benefits in neighboring areas. Conclusions:The ranking and comparison of the level of development of health indicators in provinces at the end of the Fifth Program indicated that healthcare resources and facilities were distributed unequally. If the distribution pattern is not improved, greater concentration of facilities in more beneficial areas will lead to further weakening of neighboring areas. According to the results, Qom, Kerman, Sistan and Baluchestan, Alborz, and Khuzestan provinces had less access. Therefore, due attention is needed by policy-making on these indicators. The type of indicators showed that the environmental conditions in Khuzestan, especially the problem of microorganisms in the air, have generated reluctance among physicians to work in these areas. Therefore, in addition to reviewing resource allocation as revealed by the indicators, it is necessary to use incentive levers to compensate for these problems.

Background and Aim: Little is known about the extent of inequality in OOP expenditures among COVID-19 patients and the factors contributing to it. This study aimed to examine the inequality in OOP expenditures among hospitalized COVID-19 patients and identify associated factors. Methods: The study employed the Gini coefficient as the primary measure of inequality in OOP expenditures among hospitalized COVID-19 patients. The analysis was conducted using Stata 16 software, supplemented by the Distributive Analysis Stata Package (DASP) extension. The Gini coefficient was calculated using these tools to quantify the degree of inequality and visualize it through graphs. To examine the Gini coefficient across population subgroups, the DASP extension, specifically the diginig module, was utilized. Results: The analysis of the Lorenz curve and the calculated Gini coefficient (0.69) confirmed the existence of inequality in OOP expenditures among hospitalized COVID-19 patients in this study. Furthermore, the examination of inequality across population subgroups revealed that the status and type of insurance coverage significantly contributed to the observed disparities in OOP expenditures among COVID-19 patients. However, the impact of other factors on inequality in OOP expenditures was found to be less prominent. Conclusion: The significant disparities observed in OOP expenditures, particularly related to the status and type of insurance coverage, emphasize the need for targeted interventions and programs aimed at reducing inequality in healthcare costs. Implementing initiatives to minimize financial burdens and promote equitable access to healthcare services can contribute to improved healthcare outcomes and alleviate the economic strain on patients.