Socioeconomic inequity in health care utilization, Iran

Mohammadbeigi, Abolfazl; Hassanzadeh, Jafar; Eshrati, Babak; Rezaianzadeh, Abbas

doi:10.1016/j.jegh.2013.03.006

Cited by 38 publications

(42 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Iranian government subsidizes FP program in the rural areas and cities with less than 20000 population and all primary health services are free. Our findings are consistent with of the results of a study in Markazi province in Iran (29). Other international studies in Australia, Korea, and Northern Sweden (16,19,20) show that in developed countries with universal health coverage, where the government subsidizes primary health services, all services represent a pro-poor pattern.…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Health Care Utilization Inequality in a Mixed Public-Private Health Care System: An Insight from the National Survey in Iran

et al. 2019

View full text Add to dashboard Cite

Background: Equitable health care utilization is a pillar of the Universal Health Coverage (UHC) and is also a concern to policymakers. Measuring and quantifying the inequalities are essential in assessing the progress toward achieving the UHC goals. Several studies have focused on overall measures of unfair inequality in health care utilization. The overall approaches to outpatient and inpatient services are not representative of the differences in health care usage in public and private sectors in a mixed healthcare system, like Iran. A few studies have assessed inequality measures for general practitioners (GPs), specialists (SPs), and hospital admission services in different sectors, separately. Objectives: This study aimed at measuring health care utilization inequalities in outpatient and inpatient health services in public and private sectors in Iran. Methods: In this study, national representative data derived from the utilization of health services survey (UHSS) in 2014 was used. The concentration curve (CC) and concentration index (CI) were applied to assess inequalities in health care utilization services, including the number of GP visits, SP visits, and admission in hospitals. We used ADePT software to produce a nonlinear estimation of CI for these count variables. The indirect standardization method was used to standardize the services for differences in needs by age and gender. The inequality in health care utilization was examined in both public and private sectors, separately. Results: Based on the results, public and private outpatient settings, except for the private GP visits, followed a pro-poor pattern. Inpatient admission in the public sector had a pro-poor model, but it showed a pro-rich pattern in the private sector. GP visits in the private sector changed in favor of the poorer people and SP visits in the public sector changed toward a pro-rich pattern after standardization for differences in needs. CI for family physician (FP) and GP visits in public and private sectors, and also SP visits in public and private sectors was -0.089, -0.086, -0.010, 0.025, and -0.018, respectively. CI for the inpatient admission in public and private sectors was -0.126 and 0.157, respectively. GP, SP and hospital services utilization showed a pro-poor pattern. Conclusions:The results of this study showed that most of the health care utilization followed a pro-poor model in the mixed health care system in Iran. SP visits in the public sector changed toward a pro-rich pattern after standardization for differences in needs. Although public outpatient services need more attention to maintain their pro-poor distribution, SP visits in the public sector should be more considered to follow a pro-poor pattern. Health policymakers are recommended to take measures to eliminate barriers to access this service. This may lead to reduce a gap between the poor and rich people in the utilization of the health care and moving toward the UHC.

show abstract

Section: Discussionsupporting

confidence: 92%

“…A few studies have examined health care utilization inequity in Iran (22)(23)(24)(25)(26), most of which have measured health inequalities in different health care services (27)(28)(29)(30)(31). Most of these studies have evaluated subnational data, therefore, their data cannot be used at the national level (25,26,32).…”

mentioning

confidence: 99%

Health Care Utilization Inequality in a Mixed Public-Private Health Care System: An Insight from the National Survey in Iran

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Research that has been done in India found that the highest decay prevalence has been found on children who lived at orphanage, with the average of teeth that have to be treated is 1 tooth 26.2%, 2 teeth or more 12.3%, 11.1% need tooth extraction, 19% need endodontic treatment, and 0.9% need fissure sealant treatment [19]. From the results of research in some countries, access to oral and dental care on a regular basis in the past year as in Jordan, 47.4%; in India 46% [20][21][22].…”

Section: Resultsmentioning

confidence: 99%

Socio-Dental and Family Living Condition Approach for Planning Dental Care: A Cross-sectional Study among Indonesian Students

Pasiga

Samad

Pratiwi

2018

Pesqui. bras. odontopediatria clín. integr.

View full text Add to dashboard Cite

Objective: To know the planning of dental care with a socio-dental approach. Material and Methods: Cross-sectional study has been conducted on Baubau Junior High School students, Southeast Sulawesi. The sample consisted of 209 subjects randomly selected. The social approach is known for filling out questionnaires with Family Development Index (FDI), Quality of life with OHRQoL-index using Child-OIDP (specific and generic). Family data were: family income, housing conditions (material used in the construction of the house and access to drinking water) and financial governmental support. Family income was classified into three groups. Severity status dental caries was assessed using the DMFT index. Participants were categorized into two groups: severe caries and not severe caries. Descriptive statistics were used to calculate the absolute and relative frequencies. Results: The most frequent FDI category was very severe (52.6%), while for category Child-OIDP > 1, has a value of FDI category very severe 53.1%. Normative need on FDI not severe was 71.4% with severe caries 33.3% and not severe caries 38.1%. The approach in socio-dental and family condition can be used in dental health services planning. The result of grouping of society based on index of FDI hence group of society with severe condition is equal to 83.3%. Conclusion: The living conditions of poor families in need of dental health care are normative higher and worse, and has a tendency to be more bad behavior.

show abstract

“…[ 4 5 6 7 8 9 ] People with a higher socioeconomic status use health care more than people from the lower-income groups, as also, specialist care is most used by rich people. [ 10 11 ]…”

Section: Introductionmentioning

confidence: 99%

“…On the basis of our recent studies and other literature, the educational level is an important predictor of healthy life and can also affect health care utilization. [ 11 15 16 17 ] Moreover, educational attainment is the greatest predictor of Socioeconomic Status (SES)[ 3 ] and it is common that inequity has been measured based on the different levels of socioeconomic status, but different studies have shown that there is an evidence of inequity in the different levels of education. [ 15 17 18 ] Therefore, the current study aims to determine the inequity in OHC with regard to the educational level of parents of six- to seven-year-old children in the Qom province of Iran.…”

Section: Introductionmentioning

confidence: 99%

Education-related inequity in access and utilization of oral health care in Iran

Mohammadbeigi

Arsangjang

Mohammadsalehi

et al. 2015

J Family Med Prim Care

Self Cite

View full text Add to dashboard Cite

Background:Oral health affects peoples’ lives physically and psychologically and is related to general health, quality of life, and feelings of social well-being. As the educational level is an important predictor of healthy life and can affect healthcare utilization, this study aims to estimate the inequity related to the educational level of parents on the access and utilization of oral health care (OHC) in Qom, Iran. Study Design: An analytical, cross-sectional study.Materials and Methods:Overall 281 children, six to seven years of age, were given a self-administrated questionnaire to fill. The sex, access to utilization of OHC, and educational level of the children's parents were questioned. The concentration (C) index was used as the inequity measure and statistical inference was conducted by chi square and the confidence interval of C.Statistics:The mean age of the children was 6.48 ± 0.5 years. There was not statistically significant difference in the access and utilization rate of OHC between the two sexes (P > 0.05). There was an increasing trend in the utilization rate of OHC, because of the increased educational level of the parents. The C for access and utilization rate, for different levels of fathers’ education was 0.055(-0.095 to 0.205) and 0.097(-0.068 to 0.261) and for mothers’ educational level was 0.086(-0.068 to 0.241) and 0.091(-0.81 to 0.263), respectively.Conclusion:Our results did not show evidence of sex disparity in the access and utilization of OHC in Iranian children. Also the inequity related to the educational level in access and utilization of OHC was low and not considerable.

show abstract

Socioeconomic inequity in health care utilization, Iran

Abstract: People with higher HEI used more specialist and GP care, while people with lower HEI used more HW care. The inequity in HCU was low and non-significant in different quintiles of males, females, urban and rural, as well as those who were insured.

Cited by 38 publications

References 22 publications

Health Care Utilization Inequality in a Mixed Public-Private Health Care System: An Insight from the National Survey in Iran

Health Care Utilization Inequality in a Mixed Public-Private Health Care System: An Insight from the National Survey in Iran

Socio-Dental and Family Living Condition Approach for Planning Dental Care: A Cross-sectional Study among Indonesian Students

Education-related inequity in access and utilization of oral health care in Iran

Contact Info

Product

Resources

About