Background: Iran has made great achievements in Health Sector and health financing after the implementation of the Health Sector Evolution Plan; however, there are still some provinces and expenditure groups that suffered from health payments and faced CHE. This study aimed to compare the rates of households with CHE, further to explore the different performance of factors influencing CHE before and after the HSEP in Iran.
Method: statistical data were acquired from two surveys conducted by Iran statistic Centre (2012 and 2015). A total of 18500 households in 2012 and 17649 households in 2015 were included in this study. The indices of FFC, CHE, Overshoot, and Mean Positive Overshoot are calculated to measure the fairness of financial contribution, intensity, and prevalence of catastrophic health payments.
Results: The overall measure of FFC was 0.869 and 0.909 in 2012 and 2015, respectively. The overall rate of households facing CHE reduced significantly to 0.28% just one year after the implementation of HSEP in Iran. The overshoot of CHE was 0.15% in 2012 and 0.37% in 2015, generally. Meanwhile, MPO is ranged from 12.139% to 13.119% over the threshold in 2012 and 2015, respectively. The findings revealed that the number of members with illiterate householders and the number of outpatients in households are the risk factors for CHE in both years. Besides, households with elderly members in 2012; and households with a number of members more than 5 in 2015 are more likely to experience the risk of CHE.
Conclusion: The Iranian government should pay more attention to the actual conditions in different provinces, further to make policy decisions according to the local knowledge. It is necessary to improve economic development, expand literacy and employment, and adjust policies to make greater efforts to protect outpatients, and inpatients, further to reduce the risk of CHE.
