<p>Socioeconomic Inequality in Self-Medication in Iran: Cross-Sectional Analyses at the National and Subnational Levels</p>

Abstract

Background: Self-medication (SM) is a public health concern globally. This study aimed to measure socioeconomic inequality in SM and identify its main determinants among Iranian households. Methods: A total of 38,859 households from the 2018 Household Income and Expenditure Survey (HIES) were included in the study. Data on SM, household size, age, gender and education status of the head of household, monthly household's expenditures (as a proxy for socioeconomic status), health insurance coverage and living areas and provinces were obtained for the survey. The concentration curve and the normalized concentration index (C n) were used to quantify the magnitude of socioeconomic inequality in SM among Iranian households. The C n was decomposed to identify the main determinants of socioeconomic inequality in SM in Iran. Results: The results indicated that 18.2% (95% confidence interval [CI]: 17.7% to 18.5%) of households in Iran had SM practice in the past month. The results suggested a higher concentration of SM among the rich households (C n = 0.0466; 95% CI= 0.0321 to 0.0612) in Iran. The concentration of SM among high SES households was also found in urban (0.0311; 95% CI=0.0112 to 0.0510) and rural (= 0.0513; 95% CI=0.0301 to 0.0726) areas. SM was concentrated among the rich households in Tehran, Qom, Esfahan, Ardebil, Golestan, and Sistan and Baluchestan provinces. In contrast, a higher concentration of SM was found among the poor households in Semnan, North Khorasan, Kerman, Bushehr, and South Khorasan provinces. The decomposition revealed SES of household, itself, as the main contributing factor to the concentration of SM among the wealthy households. Conclusion: This study demonstrated that SM is more concentrated among socioeconomically advantaged households in Iran. Thus, effective evidence-based interventions should be implemented to improve awareness about SM and its negative consequences. Further studies are required to investigate the consequences of SM practice among people.

Explanation of Socio-economic Inequality in Medicine Use: A Cross-sectional Analysis from Iran

“…The concentration index also revealed an inequality in favor of the poor in non-prescribed medicine use in Iran. This finding contrasts with a former Iranian study (20) that reported pro-rich socio-economic inequality in selfmedication in Iran. In previous research, authors used household budget data provided by the Statistics Center of Iran.…”

“…Another problem is international sanctions, which have had a negative impact on access to medicine in Iran. Although some studies investigated socio-economic inequality in self-medication (20) and even the use of herbal medicines (21), there is no evidence of socio-economic inequalities in prescribed medicine use in Iran. In this study, unlike previous studies, the required data was obtained from the healthcare utilization survey, which better shows the health-seeking behavior than the income and expenditure survey.…”

The Variations in Catastrophic and Impoverishing Health Expenditures, and Its Determinants in Iran: A Scoping Review

“… NO Secondary data Original Article/ English 1995–2014 Iranian households Determinants of exposure to CHE: gross domestic production (GDP)(+), gross national production(+), national income(+), and national consumption countries income(+), Unemployment(+), liquidity rate(+), inflation rate(+), budget deficit(+), population rate(+). 47 Rezaei, Satar et al 2020 ( 102 ) Measure equity in OOP payments for healthcare and the incidence of CHE among Iranian households over time. Retrospective descriptive study (measurement) WHO method Trend series regression.…”

Prevalence of self-medication among the elderly: A systematic review and meta-analysis

“…[ 14 15 16 17 ] Various studies have shown that self-medication is influenced by several factors, including age, sex, education level, marital status, socioeconomic status, health insurance coverage, place of residence, and availability of medications for individuals. [ 18 ]…”